index FNA. In the first case, a lumen-apposing metal stent (LAMS) with a coaxial pigtail stent was placed and in the second case, two pigtail stents were placed without a LAMS. Technical and clinical success was achieved in both cases. Both cases experienced complete resolution of their collections, without need for concomitant ERCP and pancreatic duct stenting. Neither patient required subsequent endoscopic, percutaneous or surgical interventions after the initial stent placement on long-term follow up. Conclusion: Pancreatic duct leak and subsequent symptomatic fluid collection after EUS-FNA is extremely uncommon especially in the absence of an inciting post-FNA pancreatitis. In our experience, EUS-guided transmural drainage of post-FNA fluid collections appears to be safe, feasible and effective in the long term, furthermore avoiding the morbidity of percutaneous or surgical management.
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