Lumen apposing metal stents for pancreatic fluid collections:Recognition and management of complications

作     者：Michael L DeSimone Akwi W Asombang Tyler M Berzin 

作者机构：Department of MedicineBeth Israel Deaconess Medical CenterHarvard Medical Schoo Center for Advanced EndoscopyDivision of GastroenterologyBeth Israel Deaconess Medical CenterHarvard Medical School 

出 版 物：《World Journal of Gastrointestinal Endoscopy》 (世界胃肠内镜杂志（英文版）（电子版）)

年 卷 期：2017年第9卷第9期

页      面：456-463页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Pancreatic fluid collection Lumen apposing metal stent Endoscopic necrosectomy Cystgastrostomy 

摘      要：For patients recovering from acute pancreatitis,the development of a pancreatic fluid collection (PFC) predicts a more complex course of recovery,and introduces difficult management decisions with regard to when,whether,and how the collection should be *** PFCs resolve spontaneously and drainage is indicated only in pseudocysts and walled-off pancreatic necrosis when the collections are causing symptoms and/or local complications such as biliary *** approaches to PFC drainage have included surgical (open or laparoscopic cystgastrostomy or pancreatic debridement),and the placement of percutaneous *** drainage techniques have emerged in the last several years as the preferred approach for most patients,when local expertise is ***-apposing metal stents(LAMS) have recently been developed as a tool to facilitate potentially safer and easier endoscopic drainage of pancreatic fluid collections,and less commonly,for other indications,such as gallbladder *** considering LAMS placement must be aware of the complications most commonly associated with LAMS including bleeding,migration,buried stent,stent occlusion,and *** of the patient complexity associated with severe pancreatitis,management of pancreatic fluid collections can be a complex and multidisciplinary *** and safe use of LAMS for patients with pancreatic fluid collections requires that the endoscopist have a full understanding of the potential complications of LAMS techniques,including how to recognize and manage expected complications.