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Endoscopic drainage of walled-off pancreatic necrosis using a novel self-expanding metal stent

Lookup NU author(s): Dr Kofi Oppong, Richard Charnley

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Abstract

Background and study aims: This report describes the use of a novel, fully covered, self-expanding metal stent (FCSEMS) for endoscopic ultrasound (EUS)-guided drainage of walled-off pancreatic necrosis (WON).Patients and methods: Patients with WON, as defined by the revised Atlanta Criteria, were included in this open-lable, two-center, observational study. The WON was punctured using a cystotome, and the FCSEMS was inserted under fluoroscopic guidance. Necrosectomy procedures were performed as necessary.Results: A total of 19 patients were included. The median maximum collection size was 15cm with a median of 50% necrosis. A total of 14/19 patients underwent necrosectomy, requiring a median of 4 procedures. Resolution or reduction in the size of collection by at least 80% was achieved in all patients. Percutaneous or surgical drainage was required in three patients. Five stents migrated or dislodged. One patient had abdominal pain post-procedure. Five patients died during follow-up (three from multi-organ failure, and two unrelated to pancreatitis).Conclusions: Use of this stent is feasible and safe for drainage of WON. However, stent displacement rates were high, and improvements to the stent design are required before it can be advocated for routine use in WON.


Publication metadata

Author(s): Huggett MT, Oppong KW, Pereira SP, Keane MG, Mitra V, Charnley RM, Nayar MK

Publication type: Article

Publication status: Published

Journal: Endoscopy

Year: 2015

Volume: 47

Issue: 10

Pages: 929-932

Print publication date: 01/10/2015

ISSN (print): 0013-726X

ISSN (electronic): 1438-8812

Publisher: Georg Thieme Verlag KG Stuttgart

URL: http://dx.doi.org/10.1055/s-0034-1392413

DOI: 10.1055/s-0034-1392413


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