ArticleEndoscopic ultrasound
Comparing EUS-guided lumen-apposing metal stents with and without integrated electrocautery for endoscopic drainage of walled-off pancreatic necrosis.
Article in Endoscopic ultrasound. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Objectives: EUS-guided drainage using lumen-apposing metal stents (LAMSs) has become standard treatment of symptomatic walled-off pancreatic necrosis (WOPN). Delivery systems with integrated electrocautery (EC) enable direct access and stent deployment, whereas the conventional stent insertion requires several steps including access using a needle or cystotome, wire insertion, and enlargement of the created tract before the stent placement. This study aimed to compare the practicality of EUS-guided procedures and their outcomes between conventional LAMSs (cLAMSs) and integrated EC (EC-LAMSs). Methods: In consecutive patients undergoing EUS-guided LAMS insertion with or without integrated EC, data on procedure time, sedation, and technical and clinical success, as well as adverse events, were analyzed. Results: From our prospectively maintained database, we analyzed 107 consecutive procedures of transmural EUS-stenting for drainage of WOPN. Thirty-nine cLAMSs and 68 EC-LAMSs were placed. Mean WOPN size was 12.9 ± 4.2 cm with mean 30% ± 15% solid necrosis.Procedure times were shorter with EC-LAMSs (18.0 ± 6.6 Conclusion: Compared with cLAMS, EC-LAMS deployment is faster and technically less demanding. This allows performing the procedure under conventional intravenous sedation and as day case procedure in selected patients.
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