PMID- 28791329
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 5
IP  - 8
DP  - 2017 Aug
TI  - Clinical impact of EUS treatment of walled-off pancreatic necrosis with dedicated 
      devices.
PG  - E784-E791
LID - 10.1055/s-0043-112494 [doi]
AB  - BACKGROUND AND STUDY AIMS:  Walled-off pancreatic necrosis (WOPN) represents the 
      major risk factor for sepsis-related multiple organ failure. Surgical debridement 
      is an invasive approach associated with high rates of adverse events (AEs) and 
      death. As an alternative, endoscopic ultrasound-guided cysto-gastro-anastomosis 
      has emerged as an effective treatment for WOPNs. Recently a new dedicated-lumen 
      apposing metal stent (LAMS) has been used with satisfactory results in treating 
      peri-pancreatic fluid collections, including WOPNs. The primary outcomes of this 
      study were to evaluate survival and clinical success. Secondary outcomes 
      included: technical success, adverse events and recurrence rate. PATIENTS AND 
      METHODS:  All consecutive patients with infected WOPN between February 2014 and 
      June 2016 were retrospectively reviewed. Patients underwent placement of a new 
      LAMS incorporated in an electrocautery-enhanced delivery system and direct 
      endoscopic necrosectomy (DEN). DEN was performed immediately after stent 
      deployment and repeated every 3 to 7 days until complete resolution. RESULTS:  In 
      the study period we treated 20 consecutive patients with infected WOPN using the 
      new LAMS. Technical success was achieved in 95 % of patients. Clinical success 
      was achieved in 73 % and 84.2 % of patients at 1 and 3 months, respectively. 
      Survival rate was 84.2 % and 79 %. Mean length of hospital stay was 19 days 
      (range 3 - 43). No AEs occurred. Patients were followed up after stent retrieval 
      for a mean time of 554,7 days (range 70 - 986) and no recurrence was observed. 
      CONCLUSIONS:  DEN following "1-step, exchange-free" LAMS positioning recorded 
      excellent results. We believe that simplicity of procedure plays a key role in 
      terms of safety.
FAU - Tarantino, Ilaria
AU  - Tarantino I
AD  - Endoscopy Service, Department of Diagnostic and Therapeutic Services, 
      IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta 
      specializzazione), Palermo, Italy.
FAU - Ligresti, Dario
AU  - Ligresti D
AD  - Endoscopy Service, Department of Diagnostic and Therapeutic Services, 
      IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta 
      specializzazione), Palermo, Italy.
FAU - Tuzzolino, Fabio
AU  - Tuzzolino F
AD  - Research Office, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad 
      alta specializzazione).
FAU - Barresi, Luca
AU  - Barresi L
AD  - Endoscopy Service, Department of Diagnostic and Therapeutic Services, 
      IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta 
      specializzazione), Palermo, Italy.
FAU - Curcio, Gabriele
AU  - Curcio G
AD  - Endoscopy Service, Department of Diagnostic and Therapeutic Services, 
      IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta 
      specializzazione), Palermo, Italy.
FAU - Granata, Antonino
AU  - Granata A
AD  - Endoscopy Service, Department of Diagnostic and Therapeutic Services, 
      IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta 
      specializzazione), Palermo, Italy.
FAU - Traina, Mario
AU  - Traina M
AD  - Endoscopy Service, Department of Diagnostic and Therapeutic Services, 
      IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta 
      specializzazione), Palermo, Italy.
LA  - eng
PT  - Journal Article
DEP - 20170807
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC5546896
COIS- Competing interests None
EDAT- 2017/08/10 06:00
MHDA- 2017/08/10 06:01
PMCR- 2017/08/01
CRDT- 2017/08/10 06:00
PHST- 2016/12/15 00:00 [received]
PHST- 2017/03/29 00:00 [accepted]
PHST- 2017/08/10 06:00 [entrez]
PHST- 2017/08/10 06:00 [pubmed]
PHST- 2017/08/10 06:01 [medline]
PHST- 2017/08/01 00:00 [pmc-release]
AID - 10.1055/s-0043-112494 [doi]
PST - ppublish
SO  - Endosc Int Open. 2017 Aug;5(8):E784-E791. doi: 10.1055/s-0043-112494. Epub 2017 
      Aug 7.