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Outcomes of a single-step endoscopic ultrasound-guided drainage of pancreatic-fluid collections using an electrocautery-enhanced coaxial lumen-apposing,self-expanding metal stent with and without fluoroscopy

引用

Gastroenterology Report 2020年第6期8卷 425-430,I0001页

作者： Babatunde Olaiya Parit Mekaroonkamol Bai-Wen Li Julia Massaad Cicily TVachaparambil Jennifer Xu vladamir lamm Hui Luo Shan-Shan Shen Hui-Min Chen Steve Keilin Field FWillingham Qiang Cai Department of Internal Medicine Marshfield ClinicMarshfieldWIUSA Division of Digestive Diseases Emory University School of MedicineAtlantaGAUSA Division of Gastroenterology King Chulalongkorn Memorial HospitalChulalongkorn University and Thai Red CrossBangkokThailand Department of Gastroenterology Shanghai General HospitalShanghai Jiaotong UniversityShanghaiP.R.China Department of Gastroenterology Xijing HospitalXi’anShaanxiP.R.China Department of Gastroenterology Nanjing Drum Tower HospitalNanjingJiangshuP.R.China Department of Gastroenterology Renji HospitalShanghai Jiaotong UniversityShanghaiP.R.China

Background:Fluoroscopy is often used during the endoscopic drainage of pancreatic-fluid collections(PFCs).An electrocautery-enhanced coaxial lumen-apposing,self-expanding metal stent(ELAMS)facilitates a single-step procedure and may avoid the need for *** study compares the treatment outcomes using ELAMS with and without ***:Patients with PFCs who had cystogastrostomy from January 2014 to February 2017 were *** groups were studied based on fluoroscopy *** success was defined as uneventful insertion of ELAMS at time of *** success was defined as(i)clinical resolution of symptoms after the procedure and(ii)>75%reduction in cyst size on computed tomography 8 weeks after stent *** events including bleeding,stent migration,and infection were ***:A total of 21 patients(13 males)had PFCs drainage with ELAMS in the study *** mean age was 51.6614.2 *** patients had walled-off necrosis while eight had a pancreatic *** mean size of the PFCs was 11.363.3 *** was used in seven cases(33%)and was associated with a longer procedure time compared to non-fluoroscopy(43.1610.4 vs 33.3610.5 min,P=0.025).This association was independent of the size,location,or type of *** had no effect on the technical success *** fluoroless procedures,the clinical resolution was 91%as compared to 71%in fluoroscopy procedures(P=0.52)and the radiologic resolution was 57%as compared to 71%in fluoroscopy procedures(P=0.65).Three cases of stent migration/displacement occurred in the fluoroless ***:ELAMS may avoid the need for fluoroscopy during *** without fluoroscopy were significantly shorter and fluoroscopy use had no impact on the technical or clinical success rates.

关键词： pancreatic-fluid collections electrocautery-enhanced coaxial lumen-apposing,self-expanding metal stent(ELAMS) fluoroscopy endoscopic ultrasound

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