Transenteric drainage of pancreatic-fluid collections with fully covered self-expanding metallic stents (with video)

Jayant P Talreja, Vanessa M Shami, Jennifer Ku, Tanya D Morris, Kristi Ellen, Michel Kahaleh
Gastrointestinal Endoscopy 2008, 68 (6): 1199-203

BACKGROUND: Drainage of pancreatic-fluid collections (PFCs) by using fully covered self-expanding metallic stents (CSEMSs) offers the option of providing a larger-diameter access fistula for drainage when compared with plastic stents.

OBJECTIVE: To evaluate the efficacy and safety of transenteric drainage of PFCs by using CSEMSs.

DESIGN: A prospective case series.

SETTING: A tertiary-referral center.

PATIENTS: Between January 2007 and September 2007, 18 patients underwent drainage of PFCs by using CSEMSs. Follow-up and final results were prospectively recorded until May 2008.

INTERVENTIONS: Placement of CSEMSs with a double-pigtail stent placed alongside (4 cases) or into the CSEMS (14 cases) to prevent migration.

MAIN OUTCOME MEASUREMENTS: The number of sessions and time to resolution of the PFCs.

RESULTS: A median of 1 session was required to achieve drainage (range 1-4) when using CSEMSs. Complications included superinfection (5), bleeding (2), and inner migration (1). A total of 17 of 18 patients (95%) responded successfully, with 14 patients (78%) achieving complete resolution of their PFC. The mean (+/- SD) time of follow-up until final resolution was 77 +/- 80 days (range 15-310 days).

CONCLUSIONS: Placement of CSEMSs seems to offer an effective and safe alternative for the drainage of PFCs. A randomized controlled trial should be performed to compare this technique with plastic-stent drainage.

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