Endosonography-guided drainage of pancreatic fluid collections with a novel lumen-apposing stent
- 12 December 2012
- journal article
- research article
- Published by Springer Science and Business Media LLC in Surgical Endoscopy
- Vol. 27 (4), 1428-1434
- https://doi.org/10.1007/s00464-012-2591-y
Abstract
The purpose of this study is to report our initial experience with a new fully covered metallic stent with a novel design (AXIOS) to prevent migration and fluid leakage, in the drainage of pancreatic fluid collections (PFC). We included nine patients from four Spanish centers undergoing endoscopic ultrasound (EUS)-guided drainage of PFC with placement of an AXIOS stent. The lesions were accessed via transgastric (n = 7), transesophageal (n = 1), and transduodenal (n = 1) by using a novel access device (NAVIX) in six cases or a 19-G needle in three. Patients were individually followed prospectively for procedure indications, demographic data, previous imaging techniques, technical aspects, clinical outcomes, complications, and follow-up after endoscopic drainage. The mean size of lesions was 105 ± 26.3 mm (range, 70–150). In six cases, cystoscopy was performed through the stent, including necrosectomy in two. Median procedure time was 25 ± 13 min. A median number of two sessions were performed. The technical success rate was 88.8 % (8/9) due to one failure of the delivery system. One patient developed a tension pneumothorax immediately after transesophageal drainage. No migrations were reported, and all stents were removed easily. All patients had a successful treatment outcome achieving complete cyst resolution. Mean time to stent retrieval was 33 ± 40 days. Mean follow-up was 50 ± 1.3 weeks (range, 45–55), and only one patient presented a recurrence 4 weeks after the stent removal. Furthermore, comparison with ten previous consecutively recruited PFC cases drained by EUS-guided using plastic pigtail stents was done. Technical and clinical successes were similar. However, two stent migrations, two recurrences, and two complications were found. The number of stents used (n = 15) and the median procedure time (42.8 ± 3.1 min) were significantly higher. Drainage of PFC using dedicated devices as this novel metallic stent with special design seems to be an effective, feasible and safe alternative technique.Keywords
This publication has 17 references indexed in Scilit:
- Mo1395 First Clinical Experience Using the AXIOS Stent and Delivery System for Internal Drainage of Pancreatic Pseudocysts and the GallbladderGastrointestinal Endoscopy, 2011
- A novel lumen-apposing stent for transluminal drainage of nonadherent extraintestinal fluid collectionsEndoscopy, 2011
- EUS-guided drainage is more successful in pancreatic pseudocysts compared with abscessesWorld Journal of Gastroenterology, 2011
- Pancreatic pseudocyst drainage guided by endoscopic ultrasoundWorld Journal of Gastrointestinal Endoscopy, 2010
- Transenteric drainage of pancreatic-fluid collections with fully covered self-expanding metallic stents (with video)Gastrointestinal Endoscopy, 2008
- Temporary Access Fistulas (TAFs) Using Covered Self-Expandable Metal Stents (cSEMS): A Feasible Tool for Interventional Pancreaticobiliary EndoscopyGastrointestinal Endoscopy, 2007
- Endoscopic-ultrasound-guided endoscopic transmural drainage of pancreatic pseudocysts and abscessesScandinavian Journal of Gastroenterology, 2007
- Endoscopic Ultrasound Drainage of Pancreatic Pseudocyst: A Prospective Comparison with Conventional Endoscopic DrainageEndoscopy, 2006
- Endoscopic Drainage of Pancreatic Pseudocysts: Long-Term Outcome and Procedural Factors Associated with Safe and Successful TreatmentEndoscopy, 2005
- Endoscopic Ultrasound-Guided Drainage of Pancreatic Pseudocysts Complicated by Portal Hypertension or by Intervening VesselsEndoscopy, 2005