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Abstract
Pancreatic fluid collections (PFCs) including pancreatic pseudocyst (PP) and walled-off necrosis (WON) are complications after acute pancreatitis. We aimed to evaluate the efficacy and safety of endoscopic ultrasound (EUS)-guided lumen-apposing metal stent (LAMS) placement to manage PFCs. Between June 2019 and May 2023, patients with symptomatic PFCs who underwent EUS-guided electrocautery-enhanced LAMS drainage were enrolled retrospectively from eight tertiary centers in Taiwan. In total, 33 [14 (42.42%) PP and 19 (57.58%) WON] patients were enrolled. Gallstones (27.27%) and abdominal pain (72.73%) were the most common etiology and indication for drainage. The technical and clinical success rates were 100% and 96.97%, respectively, and the mean procedure time was 30.55 (± 16.17) min. Complications included one (3.03%) case of self-limited bleeding; there were no cases of mortality. Seven (21.21%) patients had recurrence. Patients with disconnected pancreatic duct syndrome (DPDS) had a higher recurrence rate than those without (71.43% vs. 38.46%, p = 0.05). After replacing LAMSs with transmural double-pigtail plastic stents (DPSs) in the DPDS patients, the DPS migration rate was higher in the patients with recurrence (100% vs. 33.33%, p = 0.04). In conclusion, drainage of symptomatic PFCs with EUS-guided electrocautery-enhanced LAMS appears to be efficient and safe. Replacing LAMSs with DPSs in DPDS patients was associated with a lower recurrence rate.
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1 Far Eastern Memorial Hospital, Division of Gastroenterology and Hepatology, Department of Internal Medicine, New Taipei City, Taiwan (GRID:grid.414746.4) (ISNI:0000 0004 0604 4784); Fu Jen Catholic University, College of Medicine, New Taipei City, Taiwan (GRID:grid.256105.5) (ISNI:0000 0004 1937 1063)
2 National Taiwan University Hospital, National Taiwan University College of Medicine, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815)
3 Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung, Taiwan (GRID:grid.145695.a) (ISNI:0000 0004 1798 0922)
4 Fu Jen Catholic University Hospital, Department of Gastroenterology and Hepatology, New Taipei City, Taiwan (GRID:grid.256105.5) (ISNI:0000 0004 1937 1063)
5 Digestive Medicine Center, China Medical University Hospital, Department of Internal Medicine, Taichung, Taiwan (GRID:grid.411508.9) (ISNI:0000 0004 0572 9415)
6 Far Eastern Memorial Hospital, Division of Gastroenterology and Hepatology, Department of Internal Medicine, New Taipei City, Taiwan (GRID:grid.414746.4) (ISNI:0000 0004 0604 4784)
7 Taichung Veterans General Hospital, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung, Taiwan (GRID:grid.410764.0) (ISNI:0000 0004 0573 0731)
8 Shin Kong Wo Ho-Su Memorial Hospital, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.410764.0)
9 Changhua Christian Hospital, Department of Internal Medicine, Changhua, Taiwan (GRID:grid.413814.b) (ISNI:0000 0004 0572 7372)