Comparison of clinical efficacies and safeties of lumen-apposing metal stent and conventional-type metal stent-assisted EUS-guided pancreatic wall-off necrosis drainage: a real-life experience in a tertiary hospital

Law, Syk; Serna-Higuera, Carlos de la; Simón, P Gil; Pérez-MirandaCastillo, Manuel

doi:10.1007/s00464-017-5946-6

Cited by 22 publications

(24 citation statements)

References 27 publications

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“…[15][16][17][18][19][20][21] Although LMAS was widely perceived superior to FCSEMS and PS, our study and some other latest studies revealed that efficacy and safety of LAMS might not be substantially improved, as suggested by the treatment outcomes compared with PS 17,22,23 and FCSEMS. 24,25 One possible reason was that metal stents with larger diameter allow the bidirectional movement of contents between the gastrointestinal tract and the cavity. Therefore, when the rapid drainage of PFC (especially for drainage of the WON contents) is facilitated, undigested solid material can also easily enter the cyst cavity and cause stent occlusion or cavity infection.…”

Section: Discussioncontrasting

confidence: 45%

“…Although LMAS was widely perceived superior to FCSEMS and PS, our study and some other latest studies revealed that efficacy and safety of LAMS might not be substantially improved, as suggested by the treatment outcomes compared with PS and FCSEMS . One possible reason was that metal stents with larger diameter allow the bidirectional movement of contents between the gastrointestinal tract and the cavity.…”

Section: Discussionmentioning

confidence: 60%

“…As a newly invented fully covered metallic braided stent, LAMS with bilateral anchor flanges aimed to reduce migration, and the large diameter even permits endoscopic intervention through the inner lumen . Thus, LAMS triggered a worldwide trend of research and has become increasingly popular in recent years …”

Section: Discussionmentioning

confidence: 99%

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Comparison of three different stents for endoscopic ultrasound‐guided drainage of pancreatic fluid collection: A large retrospective study

Wang

Zhao

Meng

et al. 2019

J of Gastro and Hepatol

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Background and Aim Endoscopic transmural drainage has been recognized as the first‐line treatment for pancreatic fluid collection (PFC). Currently, three different types of stents have been extensively applied, including double pigtail plastic stent (PS), fully covered self‐expanding metal stent (FCSEMS), and novel lumen‐apposing metal stent (LAMS). Nonetheless, limited data are available about the comparison among them in terms of their clinical outcomes and safety for endoscopic ultrasound‐guided drainage of PFC. Methods The current retrospective study was carried on 160 PFC patients undergoing endoscopic ultrasound‐guided drainage from 2010 to 2018 at a single tertiary care center. Patients were divided into three groups based on different drainage ways: drainage using PS, FCSEMS, or LAMS. Results A total of 160 PFC patients (104 male and 56 female) were analyzed in this retrospective study, including 62 patients drained with PS, 28 with FCSEMS, and 70 with LAMS. Typically, the technical success (93.5% vs 96.4% vs 94.3%, P = 1.000) and treatment success rates (84.6% vs 85.2% vs 89.2%, P = 0.763) were similar between PS, FCSEMS, and LAMS. With regard to major adverse events, four patients (FCSEMS: n = 2 and LAMS: n = 2) with pseudoaneurysms developed severe bleeding; among them, 75% (3/4) of patients were observed within 2 weeks after intervention, and two patients in LAMS group died. Conclusions There are no significant differences in the clinical outcomes of PFC patients treated with PS, FCSEMS, or LAMS. Nonetheless, severe (or even fatal) bleeding may occur at the early stage after metal stent placement, which should be paid particular attention to.

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 60%

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Comparison of three different stents for endoscopic ultrasound‐guided drainage of pancreatic fluid collection: A large retrospective study

Wang

Zhao

Meng

et al. 2019

J of Gastro and Hepatol

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“…The included studies had been published between 2014 and 2019, with an enrollment period that ranged from 2005 to 2017 (Table ) . Among them, two were designed as a three‐arm study that compared efficacy among LAMS, DPPS, and FCSEMS .…”

Section: Resultsmentioning

confidence: 90%

“…In addition to studies comparing LAMS versus DPPS and FCSEMS versus DPPS, there are many studies on EUS‐guided PFC drainage comparing LAMS versus FCSEMS . These studies aimed to evaluate comparative efficacy between two types of stents in EUS‐guided PFC drainage; however, they resulted in only fragmented pairwise outcomes and could not provide comprehensive evidence including direct or indirect evidence for comparative efficacy among LAMS, DPPS, and FCSEMS.…”

Section: Introductionmentioning

confidence: 99%

Comparative efficacy of stents in endoscopic ultrasonography‐guided peripancreatic fluid collection drainage: A systematic review and network meta‐analysis

Park

Nam

et al. 2020

J of Gastro and Hepatol

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Background Although many studies have reported the efficacy of different stents for endoscopic ultrasonography (EUS)‐guided peripancreatic fluid collection (PFC) drainage, they have not completely determined which stent is superior. This network meta‐analysis comprehensively evaluated the comparative efficacy of stents used in EUS‐guided PFC. Methods We searched all relevant studies published up to February 2019 that examined the efficacy of double pigtail plastic stent (DPPS), fully covered self‐expanding metal stent (FCSEMS), and lumen‐apposing metal stent (LAMS) in EUS‐guided PFC drainage. We performed a Bayesian network meta‐analysis for clinical efficacy and adverse events. Results Fifteen studies comprising 1746 patients were included in the meta‐analysis. In terms of clinical success, no significant differences were noted in LAMS versus DPPS or LAMS versus FCSEMS (risk ratio [RR] 1.04 [95% credible interval (CrI) 0.99–1.11] and RR 0.96 [95% CrI 0.91–1.03]), respectively). FCSEMS was superior in terms of clinical success to DPPS (RR 1.09, 95% CrI 1.02–1.15). There was no significant difference in the recurrence of PFC among groups. Regarding adverse events, LAMS had a higher bleeding risk than FCSEMS (RR 6.70, 95% CrI 1.77–36.27) and tended to have a higher risk of bleeding than DPPS (RR 2.67, 95% CI 0.71–9.28). In terms of stent migration, there was no significant difference between any two groups compared. Conclusions FCSEMS had superior efficacy in terms of clinical success compared with DPPS stents. Significant superiority of LAMS to DPPS was not identified. Additionally, LAMS had the higher risk of bleeding than FCSEMS.

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Conclusive Remarks and New Perspectives

Facciorusso

Muscatiello

2021

Endoscopic Ultrasound Management of Pancreatic Lesions

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Comparison of clinical efficacies and safeties of lumen-apposing metal stent and conventional-type metal stent-assisted EUS-guided pancreatic wall-off necrosis drainage: a real-life experience in a tertiary hospital

Abstract: EUS-guided drainage of WON using FCSEMSs and LAMSs are comparable in efficacy and safety; however, the latter is associated with early stent revision.

Cited by 22 publications

References 27 publications

Comparison of three different stents for endoscopic ultrasound‐guided drainage of pancreatic fluid collection: A large retrospective study

Comparison of three different stents for endoscopic ultrasound‐guided drainage of pancreatic fluid collection: A large retrospective study

Comparative efficacy of stents in endoscopic ultrasonography‐guided peripancreatic fluid collection drainage: A systematic review and network meta‐analysis

Conclusive Remarks and New Perspectives

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