Delayed severe bleeding complications after treatment of pancreatic fluid collections with lumen-apposing metal stents

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

“…However, 75% (3/4) bleeding cases in LAMS of our study was observed at about 1 week after procedure, indicating that early bleeding might be more frequent than expected. To confirm this finding, studies reporting the time and outcomes of bleeding were systemically retrieved in Table S1 and summarized in Table . Generally, bleeding was reported in 34 patients from eight studies during the first 3 weeks, which was reported in only 16 patients from six studies 3 weeks after intervention.…”

“…Therefore, the way of removing the necrotic debris (how complete and the timing) should be further investigated. Given the aforementioned discussion, we agreed with Stecher that exchanging LAMS for plastic pigtail stents before hospital discharge might be feasible for certain patients …”

Severe bleeding is a rare event in patients receiving lumen-apposing metal stents for the drainage of pancreatic fluid collections

“…Results from our cohort as well as other recent large cohorts,1–3 6 therefore, confirm the safety of LAMS for PFC drainage. While the exact reasons for higher rates of haemorrhage observed by Bang et al (25%)4 and Stecher et al (17%)5 are unknown, it is possible that sampling bias due to small group sizes contributed to these observations.…”

“…As a limitation, the reports by Bang et al 4 and Stecher et al 5 were based on relatively small group sizes of 12 and 46 LAMS-treated patients, respectively. To investigate whether the reported safety signals are similarly observed in larger patient cohorts, we conducted a retrospective review of all patients who received LAMS for the drainage of PFCs between October 2014 and April 2017 at three medical centres in Germany (University Hospital Kiel, University Medical Centre Dresden, SRH Wald-Klinikum Gera).…”

EUS-guided treatment of WON using lumen-apposing metal stents: protocol standardisation based on the occurrence of natural healing processes

“…Moreover, Stecher et al 5 described an increased risk of bleeding even with another type of LAMS, the NAGI stent. Finally, Zhu and colleagues6 observed AEs similar to those of Bang et al ,1 such as delayed bleeding, buried stent syndrome and biliary stricture in 50% of the patients after LAMS placement.…”