PMID- 34169224
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220424
IS  - 2515-2092 (Electronic)
IS  - 2515-2084 (Print)
IS  - 2515-2084 (Linking)
VI  - 3
IP  - 1
DP  - 2020 Feb
TI  - The Evolution of EUS-Guided Transluminal Drainage for the Treatment of Pancreatic 
      Fluid Collections: A Comparison of Clinical and Cost Outcomes with Double-Pigtail 
      Plastic Stents, Conventional Metal Stents and Lumen-Apposing Metal Stents.
PG  - 26-35
LID - 10.1093/jcag/gwy049 [doi]
AB  - BACKGROUND: While most pancreatic fluid collections (PFCs) resolve spontaneously, 
      endoscopic ultrasound-guided transluminal drainage (EUS-TD) may be necessary. 
      EUS-TD has evolved from multiple double-pigtail plastic stents (DPPS) to fully 
      covered self-expanding metal stents (FCSEMS) and lumen-apposing metal stents 
      (LAMS). This study compares clinical attributes of DPPS, FCSEMS and LAMS. 
      METHODS: This is a single-centre retrospective review of EUS-TD for PFCs. The 
      primary outcome was clinical success. Secondary outcomes were technical success, 
      procedure time, hospital length of stay (HLOS), number of endoscopies, need for 
      necrosectomy, adverse events (AEs) and overall cost. RESULTS: Fifty-eight 
      patients (37 male, average age 49 years) underwent a total of 60 EUS-TD 
      procedures for PFCs (average size 11.2 cm with 29 pseudocysts and 29 walled-off 
      necrosis). Ten patients (17%) underwent EUS-TD with DPPS and 48 patients (83%) 
      with metal stents (32 FCSEMS, 16 LAMS). Overall technical and clinical success 
      was 100% and 84%, respectively. Lumen-apposing metal stents had shorter procedure 
      times (14.9 versus 63.6 DPPS, 39.1 min FCSEMS, P < 0.001), and no difference in 
      AEs (3 of 16 versus 4 of 10 DPPS, 12 of 34 FCSEMS, ns). Double-pigtail plastic 
      stents required more endoscopies (3.7 versus 2.3 LAMS, 2.3 FCSEMS, P = 0.013) and 
      necrosectomies (4 of 10 [40%]) compared with 5 of 34 [15%] in the FCSEMS group 
      and 3 of 16 [19%] in the LAMS group, respectively, P = 0.001) to achieve clinical 
      resolution. The overall cost and HLOS was not significantly different between 
      groups. CONCLUSION: The use of LAMS for PFCs is not associated with any 
      significant increase in cost despite technical (shorter procedure time) and 
      clinical advantages (shorter indwell time, reduced need for necrosectomy and no 
      increase in AEs).
CI  - (c) The Author(s) 2018. Published by Oxford University Press on behalf of the 
      Canadian Association of Gastroenterology.
FAU - Falk, Vanessa
AU  - Falk V
AD  - Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, 
      Canada.
AD  - Department of General Surgery, Medical University of Newfoundland, St. John's, 
      Newfoundland, Canada.
FAU - Kenshil, Sana
AU  - Kenshil S
AD  - Division of Gastroenterology, University of Ottawa, Ottawa, Ontario, Canada.
FAU - Sandha, Simrat
AU  - Sandha S
AD  - Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, 
      Canada.
FAU - Teshima, Christopher
AU  - Teshima C
AD  - Division of Gastroenterology, St. Michael's Hospital, Toronto, Ontario, Canada.
FAU - D'Souza, Pernilla
AU  - D'Souza P
AD  - Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, 
      Canada.
FAU - Sandha, Gurpal
AU  - Sandha G
AUID- ORCID: 0000-0002-8393-2086
AD  - Division of Gastroenterology, University of Alberta Hospital, Edmonton, Alberta, 
      Canada.
LA  - eng
PT  - Journal Article
DEP - 20180912
PL  - England
TA  - J Can Assoc Gastroenterol
JT  - Journal of the Canadian Association of Gastroenterology
JID - 101738684
PMC - PMC8218535
OTO - NOTNLM
OT  - Cyst drainage
OT  - Endoscopic ultrasound
OT  - Metal stent
OT  - Pancreatic fluid collections
EDAT- 2018/09/12 00:00
MHDA- 2018/09/12 00:01
PMCR- 2018/09/12
CRDT- 2021/06/25 06:56
PHST- 2021/06/25 06:56 [entrez]
PHST- 2018/09/12 00:00 [pubmed]
PHST- 2018/09/12 00:01 [medline]
PHST- 2018/09/12 00:00 [pmc-release]
AID - gwy049 [pii]
AID - 10.1093/jcag/gwy049 [doi]
PST - epublish
SO  - J Can Assoc Gastroenterol. 2018 Sep 12;3(1):26-35. doi: 10.1093/jcag/gwy049. 
      eCollection 2020 Feb.