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.
RCT Entities:
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.
Authors: Carlo Fabbri; Carmelo Luigiano; Andrea Lisotti; Vincenzo Cennamo; Clara Virgilio; Giancarlo Caletti; Pietro Fusaroli Journal: World J Gastroenterol Date: 2014-07-14 Impact factor: 5.742
Authors: Michel Kahaleh; Everson L A Artifon; Manuel Perez-Miranda; Kapil Gupta; Takao Itoi; Kenneth F Binmoeller; Marc Giovannini Journal: World J Gastroenterol Date: 2013-03-07 Impact factor: 5.742