EUS-guided splenic and hepatic subcapsular collection drainage using lumen apposing metal stents

Aims EUS guided cystogastrostomy using lumen-apposing metal stents (LAMS) is a recognised method of draining pancreatic fluid collections. LAMS have been used to drain other abdominal collections, however hepatic and splenic subcapsular collections are commonly drained using a percutaneous approach. We present a retrospective series of EUS guided drainage of these collections using LAMS, assessing the technical and clinical outcome.

Methods We performed a retrospective review of all patients who underwent LAMS insertion for hepatic and splenic subcapsular collection drainage at a major UK HPB centre between March 2021 and September 2022. Demographic and clinical details were recorded. Primary outcome measures were technical and clinical success. Technical success was defined as safe deployment of the stent. Clinical success was defined as improvement in patients’ clinical condition, inflammatory markers and imaging (reduction of collection < 50% or+<+5 cm in size after two weeks). All patients were followed up and all adverse events were recorded as a secondary outcome measure. 20 mm x 10mm diameter LAMS (Axios, Boston Scientific) were used in all patients. The average size of the collection was 7.9cm. All patients underwent contrast enhanced CT scan pre and post EUS intervention.

Results A total of 11 patients underwent LAMS insertion for hepatic (2) and splenic (9) subcapsular collection. The majority of patients were male and the mean age was 63. Technical and clinical success was 100% with no major complication.

Conclusions In patients with hepatic or splenic subcapsular collection, EUS guided LAMS drainage has a high rate of clinical success with an excellent safety profile.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
14 April 2023