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

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• 作者：Natsuyo Yamamoto ; MD ; PhD¹ ; Hiroyuki Isayama ; MD ; PhD¹ ; ; Hiroshi Kawakami ; MD ; PhD² ; Naoki Sasahira ; MD ; PhD³ ; Tsuyoshi Hamada ; MD¹ ; Yukiko Ito ; MD ; PhD⁴ ; Naminatsu Takahara ; MD¹ ; Rie Uchino ; MD¹ ; Koji Miyabayashi ; MD ; PhD¹ ; Suguru Mizuno ; MD ; PhD¹ ; Hirofumi Kogure ; MD ; PhD⁵ ; Takashi Sasaki ; MD ; PhD¹ ; Yousuke Nakai ; MD ; PhD¹ ; Masaki Kuwatani ; MD ; PhD² ; Kenji Hirano ; MD ; PhD¹ ; Minoru Tada ; MD ; PhD¹ ; Kazuhiko Koike ; MD ; PhD¹
• 关键词：DEN ; direct endoscopic necrosectomy ; FCSEMS ; fully covered ; self-expandable ; metal stent ; PFC ; pancreatic fluid collection ; WOPN ; walled-off pancreatic necrosis
• 刊名：Gastrointestinal Endoscopy
• 出版年：2013
• 出版时间：May, 2013
• 年：2013
• 卷：77
• 期：5
• 页码：809-814
• 全文大小：1409 K

文摘

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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.