Endoscopic treatment of large pancreatic fluid collections (PFC) using self-expanding metallic stents (SEMS) – a two-center experience
Background/study aim: During the last several years, endoscopic ultrasound (EUS)-guided pancreatic fluid collections’ (PFC) drainage has evolved into the preferred drainage technique. Recently, self-expanding metallic stents (SEMS) have bee...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Georg Thieme Verlag KG
2014-10-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1390796 |
| _version_ | 1819085254207471616 |
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| author | Dalton Marques Chaves Klaus Mönkemüller Fred Carneiro Bruno Medrado Marcos dos Santos Stephanie Wodak Sílvia Reimão Paulo Sakai Eduardo de Moura |
| author_facet | Dalton Marques Chaves Klaus Mönkemüller Fred Carneiro Bruno Medrado Marcos dos Santos Stephanie Wodak Sílvia Reimão Paulo Sakai Eduardo de Moura |
| author_sort | Dalton Marques Chaves |
| collection | DOAJ |
| description | Background/study aim: During the last several years, endoscopic ultrasound
(EUS)-guided pancreatic fluid collections’ (PFC) drainage has evolved into the
preferred drainage technique. Recently, self-expanding metallic stents (SEMS)
have been used as an alternative to double pigtail stents, with the advantage of
providing a larger diameter fistula, thereby decreasing the risk of early
obstruction and also allowing for direct endoscopic exploration of the cavity.
The aim of this study was to evaluate the technical and clinical success,
safety, and outcome of patients undergoing EUS-guided drainage of complex PFC
using SEMS.
Patients/materials and methods: The study was conducted at two tertiary
hospitals from January 2010 to January 2013. All patients with PFC referred for
endoscopic drainage were enrolled in a prospective database. The inclusion
criteria were: (1) patients with pseudocysts or walled-off necrosis based on the
revised Atlanta classification; (2) symptomatic patients with thick PFC; (3) PFC
that persisted more than 6 weeks; and (4) large PFC diameter (≥ 9 cm). The
exclusion criteria consisted of coagulation disorders, PFC bleeding or
infection, and failure-to-inform written consent.
Results: A total of 16 patients (9 females, 7 males; mean age 52.6, range
20 – 82) underwent EUS drainage with SEMS. There were 14 cases of pseudocysts
and 2 cases of walled-off necrosis. The etiologies of the PFC were mainly
gallstones (8 of 16 patients, 50 %) and alcohol (5 of 16 patients, 31 %).
Technical success was achieved in 100 % of the cases. All patients had a
complete resolution of the PFC.
Conclusion: Transmural EUS-guided drainage of complex PFC using SEMS is
feasible, appears safe, and is efficacious. However, the exchange of the UC
(uncovered)-SEMS for plastic stents is mandatory within 1 week. Future
prospective studies, preferably multicenter studies, comparing SEMS versus
traditional plastic stents for the drainage of PFC are warranted. |
| first_indexed | 2024-12-21T21:01:26Z |
| format | Article |
| id | doaj.art-fa069f745828441d964427a9ab68be2e |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-12-21T21:01:26Z |
| publishDate | 2014-10-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-fa069f745828441d964427a9ab68be2e2022-12-21T18:50:27ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362014-10-010204E224E22910.1055/s-0034-1390796Endoscopic treatment of large pancreatic fluid collections (PFC) using self-expanding metallic stents (SEMS) – a two-center experienceDalton Marques Chaves0Klaus Mönkemüller1Fred Carneiro2Bruno Medrado3Marcos dos Santos4Stephanie Wodak5Sílvia Reimão6Paulo Sakai7Eduardo de Moura8Department of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, BrazilDepartment of Gastroenterology, Gastrointestinal Endoscopy Unit, University of Alabama at Birmingham, Birmingham, AL, USADepartment of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, BrazilDepartment of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, BrazilDepartment of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, BrazilDepartment of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, BrazilDepartment of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, BrazilDepartment of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, BrazilDepartment of Gastrointestinal Endoscopy, University of São Paulo, São Paulo, BrazilBackground/study aim: During the last several years, endoscopic ultrasound (EUS)-guided pancreatic fluid collections’ (PFC) drainage has evolved into the preferred drainage technique. Recently, self-expanding metallic stents (SEMS) have been used as an alternative to double pigtail stents, with the advantage of providing a larger diameter fistula, thereby decreasing the risk of early obstruction and also allowing for direct endoscopic exploration of the cavity. The aim of this study was to evaluate the technical and clinical success, safety, and outcome of patients undergoing EUS-guided drainage of complex PFC using SEMS. Patients/materials and methods: The study was conducted at two tertiary hospitals from January 2010 to January 2013. All patients with PFC referred for endoscopic drainage were enrolled in a prospective database. The inclusion criteria were: (1) patients with pseudocysts or walled-off necrosis based on the revised Atlanta classification; (2) symptomatic patients with thick PFC; (3) PFC that persisted more than 6 weeks; and (4) large PFC diameter (≥ 9 cm). The exclusion criteria consisted of coagulation disorders, PFC bleeding or infection, and failure-to-inform written consent. Results: A total of 16 patients (9 females, 7 males; mean age 52.6, range 20 – 82) underwent EUS drainage with SEMS. There were 14 cases of pseudocysts and 2 cases of walled-off necrosis. The etiologies of the PFC were mainly gallstones (8 of 16 patients, 50 %) and alcohol (5 of 16 patients, 31 %). Technical success was achieved in 100 % of the cases. All patients had a complete resolution of the PFC. Conclusion: Transmural EUS-guided drainage of complex PFC using SEMS is feasible, appears safe, and is efficacious. However, the exchange of the UC (uncovered)-SEMS for plastic stents is mandatory within 1 week. Future prospective studies, preferably multicenter studies, comparing SEMS versus traditional plastic stents for the drainage of PFC are warranted.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1390796 |
| spellingShingle | Dalton Marques Chaves Klaus Mönkemüller Fred Carneiro Bruno Medrado Marcos dos Santos Stephanie Wodak Sílvia Reimão Paulo Sakai Eduardo de Moura Endoscopic treatment of large pancreatic fluid collections (PFC) using self-expanding metallic stents (SEMS) – a two-center experience Endoscopy International Open |
| title | Endoscopic treatment of large pancreatic fluid collections (PFC)
using self-expanding metallic stents (SEMS) – a two-center
experience |
| title_full | Endoscopic treatment of large pancreatic fluid collections (PFC)
using self-expanding metallic stents (SEMS) – a two-center
experience |
| title_fullStr | Endoscopic treatment of large pancreatic fluid collections (PFC)
using self-expanding metallic stents (SEMS) – a two-center
experience |
| title_full_unstemmed | Endoscopic treatment of large pancreatic fluid collections (PFC)
using self-expanding metallic stents (SEMS) – a two-center
experience |
| title_short | Endoscopic treatment of large pancreatic fluid collections (PFC)
using self-expanding metallic stents (SEMS) – a two-center
experience |
| title_sort | endoscopic treatment of large pancreatic fluid collections pfc using self expanding metallic stents sems a two center experience |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1390796 |
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