Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12330
Title: Management of pancreatic collections with a novel endoscopically placed fully covered self-expandable metal stent: a national experience (with videos).
Authors: Chandran, Sujievvan;Efthymiou, Marios;Kaffes, Arthur;Chen, John Wei;Kwan, Vu;Murray, Michael;Williams, David;Nguyen, Nam Quoc;Tam, William;Welch, Christine;Chong, Andre;Gupta, Saurabh;Devereaux, Ben;Tagkalidis, Peter;Parker, Frank;Vaughan, Rhys B
Affiliation: Department of Gastroenterology, Austin Health Melbourne, Victoria, Australia.
Department of Gastroenterology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Department of Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Department of Gastroenterology, Westmead Hospital, Sydney, New South Wales, Australia.
Department of Gastroenterology, Pindara Private Hospital, Gold Coast, Queensland, Australia.
Department of Gastroenterology, St. Vincent's Hospital, Sydney, New South Wales, Australia.
Department of Gastroenterology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Department of Gastroenterology, Lyell McEwin Hospital, Adelaide, South Australia, Australia.
Department of Gastroenterology, Townsville Hospital, Townsville, Queensland, Australia.
Department of Gastroenterology, Fremantle Hospital, Fremantle, Western Australia, Australia.
Department of Gastroenterology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
Department of Gastroenterology, Royal Brisbane Hospital, Brisbane, Queensland, Australia.
Department of Gastroenterology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
Department of Anaesthetics, Austin Health, Melbourne, Victoria, Australia.
Department of Gastroenterology, Austin Health Melbourne, Victoria, Australia; Department of Medicine, Austin Health, University of Melbourne, Melbourne, Victoria, Australia.
Issue Date: 2-Aug-2014
Citation: Gastrointestinal Endoscopy 2014; 81(1): 127-35
Abstract: Recent medical literature on novel lumen-apposing stents for the treatment of pancreatic fluid collections (PFCs) is limited by small numbers, solo operators, and single-center experience.To evaluate a recently developed lumen-apposing, fully covered self-expandable metal stent (FCSEMS) in the management of PFCs.Retrospective case series.Thirteen tertiary and private health care centers across Australia.Forty-seven patients (median age 51 years) who underwent endoscopic management of PFCs.Insertion of FCSEMS after PFC puncture under EUS guidance. A subgroup of 9 patients underwent direct endoscopic necrosectomy.Technical and clinical success rate, adverse event rate.The technical success rate was 53 of 54 patients (98.1%), and the initial clinical success rate was 36 of 47 (76.6%), which was sustained for more than 6 months in 34 of 36 (94.4%). Early adverse events included 4 cases (7.4%) of stent migration during direct endoscopic necrosectomy, 4 cases (7.4%) of sepsis, 1 case (1.9%) of bleeding, and 1 case (1.9%) of stent migration into the fistula tract. Late adverse events were¬†6 (11.1%) spontaneous stent migrations, 3 (5.6%) recurrent stent occlusions, 3 (5.6%) tissue ingrowth/overgrowth, and 2 (3.7%) bleeding into PFC. The majority of stents inserted (48 of 54, 88.9%) and removed (31 of 35, 88.6%) in our study were described by the operator as superior to pigtail stents with regard to ease of use.Retrospective study.Although FCSEMSs are technically easier to insert and remove compared with traditional pigtail stents, there are significant limitations to the widespread use of FCSEMSs in the management of PFCs. These include cost, adverse events, and lower-than-expected resolution rates.
Internal ID Number: 25092104
URI: http://ahro.austin.org.au/austinjspui/handle/1/12330
DOI: 10.1016/j.gie.2014.06.025
URL: http://www.ncbi.nlm.nih.gov/pubmed/25092104
Type: Journal Article
Appears in Collections:Journal articles

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