CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(03): E259-E265
DOI: 10.1055/s-0043-125362
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Multicenter experience from the UK and Ireland of use of lumen-apposing metal stent for transluminal drainage of pancreatic fluid collections

Suresh Vasan Venkatachalapathy
 1  Nottingham University Hospitals NHS Trust And University Of Nottingham – Nottingham Biomedical Research Centre and NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom of Great Britain and Northern Ireland
,
Noor Bekkali
 2  Freeman Hospital – HPB Unit, Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
,
Stephen Pereira
 3  University College London – UCL Institute of Hepatology, London, London, United Kingdom of Great Britain and Northern Ireland
 4  University College Hospitals NHS Foundation Trust – Department of Gastroenterology, London, London, United Kingdom of Great Britain and Northern Ireland
,
Gavin Johnson
 4  University College Hospitals NHS Foundation Trust – Department of Gastroenterology, London, London, United Kingdom of Great Britain and Northern Ireland
,
Kofi Oppong
 2  Freeman Hospital – HPB Unit, Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
,
Manu Nayar
 2  Freeman Hospital – HPB Unit, Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
,
John Leeds
 2  Freeman Hospital – HPB Unit, Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom of Great Britain and Northern Ireland
,
Bharat Paranandi
 5  Leeds Teaching Hospitals NHS Trust – Gastroenterology, Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
,
Ian Penman
 6  Royal Infirmary of Edinburgh- Gastroenterology, Edinburgh, Edinburgh, United Kingdom of Great Britain and Northern Ireland
,
Nicholas Carroll
 7  Cambridge University Hospitals NHS Foundation Trust – Radiology, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
,
Edmund Godfrey
 7  Cambridge University Hospitals NHS Foundation Trust – Radiology, Cambridge, Cambridgeshire, United Kingdom of Great Britain and Northern Ireland
,
Martin James
 1  Nottingham University Hospitals NHS Trust And University Of Nottingham – Nottingham Biomedical Research Centre and NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom of Great Britain and Northern Ireland
,
Guruprasad Aithal
 1  Nottingham University Hospitals NHS Trust And University Of Nottingham – Nottingham Biomedical Research Centre and NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom of Great Britain and Northern Ireland
,
Colin McKay
 8  Glasgow Royal Infirmary – Pancreatic Surgery, Glasgow, Glasgow, United Kingdom of Great Britain and Northern Ireland
,
John Devlin
 9  King's College Hospital NHS Foundation Trust – Hepatology, London, London, United Kingdom of Great Britain and Northern Ireland
,
Terry Wong
10  Guys and St Thomas' NHS Foundation Trust – Gastroenterology, London, United Kingdom of Great Britain and Northern Ireland
,
Alistair Makin
11  Central Manchester University Hospitals NHS Foundation Trust – Gastroenterology, Manchester, Greater Manchester, United Kingdom of Great Britain and Northern Ireland
,
Barbara Ryan
12  Tallaght Hospital/Trinity College Dublin – Gastroenterology, Dublin, Ireland
,
Matthew Huggett
 5  Leeds Teaching Hospitals NHS Trust – Gastroenterology, Leeds, Leeds, United Kingdom of Great Britain and Northern Ireland
› Author Affiliations
Further Information

Publication History

submitted 23 August 2017

accepted after revision 22 November 2017

Publication Date:
28 February 2018 (online)

Abstract

Background and study aims Pancreatic fluid collection (PFC) is a common complication of pancreatitis for which endoscopic ultrasound-guided drainage is first-line treatment. A new single-device, lumen-apposing, covered self-expanding metal stent (LAMS) has been licensed for PFC drainage. We therefore present our multicenter experience with the LAMS for PFC drainage in a multicenter prospective case series to assess success and complication rates.

Patients and methods All adult patients from 11 tertiary centers who had LAMS placement for PFC from July 2015 to July 2016 were included. Data including indications, technical success, clinical success, collection resolution, stent removal, early and late adverse events (AEs), mortality and recurrence at 6 months were collected.

Results 116 patients, median age 52.5 years (range 16 – 80) and 67 % male, were treated with a single LAMS in each case. The indication was walled off necrosis (WON) in 70 and pseudocyst in 46. Median size of the PFC was 11 cm (5 – 21 cm) and the estimated median necrotic volume in WON was 30 % (5 % – 90 %). Stent insertion was technically successful in 115 (99.1 %) and clinically successful in 109 (94 %). Early serious AEs (SAEs): n = 7 sepsis, n = 1 stent blockage with food, n = 1 stent migration requiring laparotomy, n = 1 stent dislodgement and n = 1 bleeding requiring emboliZation. Late AEs: n = 1 buried stent and n = 1 esophageal fistula. Non-procedure-related deaths: n = 3 (2.5 %).

Conclusion This multicenter case series demonstrates that use of the new LAMS is feasible, effective and relatively safe in draining PFC with a technical success rate of 99 % and cumulative SAE rate of 11.2 %.