ArticleVideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy2020
Placing a lumen-apposing metal stent despite ascites: feasibility and safety.
Article in VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Endoscopic Gallbladder Drainage EUS LAMS vs. ERCP Trans-papillary Drainage.Current gastroenterology reports · 2025Review
- Drainage of Afferent Limb Obstruction via the Trans-gastric-bile Duct Formed after Endoscopic Ultrasound-guided Hepaticogastrostomy in a Patient with Pancreatic Cancer.Internal medicine (Tokyo, Japan) · 2023Article
- Gastric outlet obstruction with ascites: EUS-guided gastro-enterostomy is feasible.Endoscopy international open · 2021Article
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsPlacing a lumen-apposing metal stent (LAMS) through ascites carries serious risks, including death from leakage around the LAMS and failure to create a mature fistula between the 2 lumens. However, sometimes no options exist or are equally dangerous. We present 5 patients who underwent LAMS placement despite ascites in 2 different locations.
methodsThis is a retrospective review of 5 patients who underwent LAMS placement despite ascites in 2 different locations from 2016 to 2018.
resultsThree patients with cholecystitis and 2 patients with afferent limb syndrome and severe ascites were treated with a combination of preprocedural and intraprocedural paracentesis. Serum ascites albumin gradient was measured. Weight was recorded daily. Patients were encouraged to sleep at an incline, and periodic paracentesis (every 3-7 days) was performed when ascites reaccumulated over 4 weeks. Median volume of ascites aspirated was 2 L preprocedurally and 300 mL intraprocedurally. Only 1 patient had ascites with a high serum ascites albumin gradient and was treated with diuretics. Technical and clinical success was achieved in all 5 patients without any adverse events over a median follow-up of 28 weeks.
conclusionsIn situations in which no better options remain, LAMS placement appears to be safe after adequate and aggressive treatment of the underlying ascites pre-, intra-, and postprocedurally. Larger studies are needed to establish the safety of this approach.
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