Preliminary report on a new, fully covered, metal stent designed for the treatment of pancreatic fluid collections

Gastrointest Endosc. 2013 May;77(5):809-14. doi: 10.1016/j.gie.2013.01.009. Epub 2013 Feb 26.

Abstract

Background: Endoscopic transluminal treatment of pancreatic fluid collections (PFC) has been reported as an effective alternative approach to surgical treatment. A wide, short stent with an anti-migration system has been developed.

Objective: To evaluate a newly developed, fully covered, self-expandable metal stent (FCSEMS) customized for cystogastrostomy.

Design: Retrospective case series.

Setting: Tertiary-care academic medical centers and affiliated hospitals.

Patients: Nine patients who underwent endoscopic treatment of PFCs (5 with pseudocysts and 4 with walled-off pancreatic necrosis).

Intervention: Stent deployment after endoscopic US-guided puncture. Irrigation and necrosectomy were performed at the discretion of the endoscopist.

Main outcome measurements: Technical and clinical success rate, complications, and removability.

Results: The FCSEMS was inserted successfully in all cases (9/9, 100%). Clinical success was achieved in 7 of 9 cases (77.8%). No early complications associated with the procedure were observed. Late complications were observed in 2 cases (bleeding and asymptomatic migration). The FCSEMS was removed without any complications in all 6 cases where it was attempted after the procedure had been completed (100%).

Limitations: This was a retrospective evaluation of a small number of cases. The FCSEMS was always inserted via the transgastric route. Follow-up duration was short.

Conclusion: The endoscopic approach that uses this new FCSEMS is feasible for the treatment of PFCs. However, further evaluation is required.

MeSH terms

  • Adult
  • Aged
  • Device Removal
  • Endoscopy, Digestive System / instrumentation*
  • Equipment Design
  • Female
  • Humans
  • Male
  • Middle Aged
  • Necrosis / surgery
  • Pancreas / pathology*
  • Pancreas / surgery*
  • Pancreatic Pseudocyst / surgery*
  • Postoperative Hemorrhage / etiology*
  • Prosthesis Failure
  • Prosthesis Implantation / adverse effects
  • Retrospective Studies
  • Stents* / adverse effects
  • Ultrasonography, Interventional