Fluoroscopy-assisted vs fluoroless endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections: A comparative study

Consiglieri, Claudia F.; Gornals, Joan B.; Busquets, Juli; Peláez, Núria; Secanella, Lluís; De-La-Hera, Meritxell; Sanzol, R.; Fabregat, Joan; Castellote, José

doi:10.1016/j.gastrohep.2017.07.008

Cited by 14 publications

(6 citation statements)

References 20 publications

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“…The majority of the studies included in this meta-analysis were single cohort retrospective studies with few comparative studies and only one RCT. To provide data on WON only 35 , several studies had to be excluded due to the reporting of WON and pseudocyst outcomes together 11 36 37 . Data were collected by expert endoscopists at large tertiary referral centers; however, a small 2019 study 38 reported successful use of LAMS to treat WON in a community hospital.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis: systematic review and meta-analysis

et al. 2020

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Background and study aims Lumen-apposing metal stents (LAMS) are increasingly used for drainage of walled-off pancreatic necrosis (WON). Recent studies suggested greater adverse event (AE) rates with LAMS for WON. We conducted a systematic review and meta-analysis to compare the safety and efficacy of LAMS with double-pigtail plastic stents (DPPS) for endoscopic drainage of WON. The primary aim was to evaluate stent-related AEs. Methods In October 2019, we searched the Ovid (Embase, MEDLINE, Cochrane) and Scopus databases for studies assessing a specific LAMS or DPPS for WON drainage conducted under EUS guidance. Safety outcomes were AE rates of bleeding, stent migration, perforation, and stent occlusion. Efficacy outcomes were WON resolution and number of procedures needed to achieve resolution. A subanalysis including non-EUS-guided cases was performed. Results Thirty studies including one randomized controlled trial (total 1,524 patients) were analyzed. LAMS were associated with similar bleeding (2.5 % vs. 4.6 %, P = 0.39) and perforation risk (0.5 % vs. 1.1 %, P = 0.35) compared to DPPS. WON resolution (87.4 % vs. 87.5 %, P = 0.99), number of procedures to achieve resolution (2.09 vs. 1.88, P = 0.72), stent migration (5.9 % vs. 6.8 %, P = 0.79), and stent occlusion (3.8 % vs. 5.2 %, P = 0.78) were similar for both groups. Inclusion of non-EUS-guided cases led to significantly higher DPPS bleeding and perforation rates. Conclusions LAMS and DPPS were associated with similar rates of AEs and WON resolution when limiting analysis to EUS-guided cases. Higher bleeding rates were seen in historical studies of DPPS without EUS guidance. Additional high-quality studies of WON treatment using consistent outcome definitions are needed.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis: systematic review and meta-analysis

et al. 2020

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“…Recently, Braden et al demonstrated similar outcomes using fully covered self-expandable metal stents (FCSEMSs) without fluoroscopy for drainage of WON [ 22 ]. Consiglieri et al also reported similar clinical as well as technical success of EUS-guided transmural drainage of (peri)pancreatic collections with and without fluoroscopic guidance [ 23 ].…”

Section: Fluoroscopic Versus Nonfluoroscopic Endoscopic Transmural Dr...mentioning

confidence: 96%

Endoscopic step up: When and how

Jearth

Rana

2022

Surgery Open Science

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“…What is more, a LAMS can be removed. It can be implanted endoscopically/endosonographically without any radiological assistance, but having an imaging modality available in the event of complications is definitely an advantage [ 52 ]. The learning curve for this therapeutic intervention is decidedly shorter than for staging carried out for purely diagnostic purposes or the endosonographic morphological assessment of rare tumors of the biliopancreatic system.…”

Section: The Most Important Diagnostic and Therapeutic Interventional...mentioning

confidence: 99%

Diagnostic and Therapeutic Indications for Endoscopic Ultrasound (EUS) in Patients with Pancreatic and Biliary Disease—Novel Interventional Procedures

Prager

Sebesta

2022

Current Oncology

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There is growing evidence supporting the substantial, essential and indispensable role of endoscopic ultrasound (EUS) as a key diagnostic armamentarium for upper GI oncologic surgery. Well described in countless publications, EUS holds that position in gastroenterological expert centers all over Europe. Despite its undisputable contributions to oncologic upper GI surgery, the availability of this technique at the expert level shows up in an irregular spread pattern. Endoscopic ultrasound’s primary use during the first few years after its creation was the detection of pancreatic cancer. From then on, EUS developed in different directions, becoming a diagnostic tool that increasingly better defines its status as a method of minimally invasive therapeutic applications and a useful addition to surgical options. As a result, several surgical interventions could even be replaced by ultrasound-targeted interventions. This process took place in just a few years and was made possible by technical development that sensibly combined high-resolution ultrasound with therapeutic endoscopy. The present article will serve to cover the most prevalent uses with supporting data considering the growing list of suggested indications for EUS while also examining cutting-edge initiatives that might soon become the standard of clinical practice. Endoscopic centers with high expertise are needed to train future experts in the growing field of EUS interventions.

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Fluoroscopy-assisted vs fluoroless endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections: A comparative study

Cited by 14 publications

References 20 publications

Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis: systematic review and meta-analysis

Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis: systematic review and meta-analysis

Endoscopic step up: When and how

Diagnostic and Therapeutic Indications for Endoscopic Ultrasound (EUS) in Patients with Pancreatic and Biliary Disease—Novel Interventional Procedures

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