The Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video)

Background/Aims: Various lumen-apposing metal stents (LAMS) have been used for the endoscopic ultrasound-guided transmural drainage (EUS-TD) of postoperative pancreatic fluid collections (POPFC) and peripancreatic fluid collections (PFC). In this study, we aimed to assess the efficacy and safety of...

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Main Authors: Sung Hyun Cho, Yoonchan Lee, Tae Jun Song, Dongwook Oh, Dong-Wan Seo
Format: Article
Language:English
Published: Gastroenterology Council for Gut and Liver 2025-05-01
Series:Gut and Liver
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Online Access:http://gutnliver.org/journal/view.html?doi=10.5009/gnl240452
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author Sung Hyun Cho
Yoonchan Lee
Tae Jun Song
Dongwook Oh
Dong-Wan Seo
author_facet Sung Hyun Cho
Yoonchan Lee
Tae Jun Song
Dongwook Oh
Dong-Wan Seo
author_sort Sung Hyun Cho
collection DOAJ
description Background/Aims: Various lumen-apposing metal stents (LAMS) have been used for the endoscopic ultrasound-guided transmural drainage (EUS-TD) of postoperative pancreatic fluid collections (POPFC) and peripancreatic fluid collections (PFC). In this study, we aimed to assess the efficacy and safety of novel electrocautery-enhanced LAMSs (Hot-Plumber with Z-EUS IT) with different inter-flange lengths (13 to 33 mm) for managing POPFC and PFC. Methods: We reviewed the interventional EUS database of Asan Medical Center to identify consecutive patients with POPFC or PFC who underwent EUS-TD with the novel LAMSs between April 2023 and December 2023. Technical success, clinical success, and adverse events were evaluated. Results: Ten patients (5 with POPFCs and 5 with PFCs) were included in the analysis. The technical and clinical success rates were 100% and 90%, respectively. The LAMS was placed using either the freehand technique (n=5) or the over-the-guide wire technique (n=5). One patient successfully underwent endoscopic necrosectomy for walled-off necrosis through a novel LAMS. Two patients experienced adverse events (one stent migration and one infection). The LAMS was removed in 7 out of 10 patients after resolution of the fluid collection at a median of 61 days (interquartile range, 31 to 69 days) post-LAMS placement. Conclusions: EUS-TD using the novel LAMS for POPFC and PFC demonstrated high efficacy and an acceptable safety profile. This novel LAMS represents a viable option when selecting stents for EUS-guided drainage of the POPFC and PFC.
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spelling doaj-art-dba99cf2806e48e8ad6df88b552e87bf2025-08-20T03:52:57ZengGastroenterology Council for Gut and LiverGut and Liver1976-22832025-05-0119345446110.5009/gnl240452gnl240452The Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video)Sung Hyun Cho0Yoonchan Lee1Tae Jun Song2Dongwook Oh3Dong-Wan Seo4Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaDepartment of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground/Aims: Various lumen-apposing metal stents (LAMS) have been used for the endoscopic ultrasound-guided transmural drainage (EUS-TD) of postoperative pancreatic fluid collections (POPFC) and peripancreatic fluid collections (PFC). In this study, we aimed to assess the efficacy and safety of novel electrocautery-enhanced LAMSs (Hot-Plumber with Z-EUS IT) with different inter-flange lengths (13 to 33 mm) for managing POPFC and PFC. Methods: We reviewed the interventional EUS database of Asan Medical Center to identify consecutive patients with POPFC or PFC who underwent EUS-TD with the novel LAMSs between April 2023 and December 2023. Technical success, clinical success, and adverse events were evaluated. Results: Ten patients (5 with POPFCs and 5 with PFCs) were included in the analysis. The technical and clinical success rates were 100% and 90%, respectively. The LAMS was placed using either the freehand technique (n=5) or the over-the-guide wire technique (n=5). One patient successfully underwent endoscopic necrosectomy for walled-off necrosis through a novel LAMS. Two patients experienced adverse events (one stent migration and one infection). The LAMS was removed in 7 out of 10 patients after resolution of the fluid collection at a median of 61 days (interquartile range, 31 to 69 days) post-LAMS placement. Conclusions: EUS-TD using the novel LAMS for POPFC and PFC demonstrated high efficacy and an acceptable safety profile. This novel LAMS represents a viable option when selecting stents for EUS-guided drainage of the POPFC and PFC.http://gutnliver.org/journal/view.html?doi=10.5009/gnl240452endosonography; pancreatic pseudocyst; stents; drainage
spellingShingle Sung Hyun Cho
Yoonchan Lee
Tae Jun Song
Dongwook Oh
Dong-Wan Seo
The Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video)
Gut and Liver
endosonography; pancreatic pseudocyst; stents; drainage
title The Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video)
title_full The Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video)
title_fullStr The Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video)
title_full_unstemmed The Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video)
title_short The Efficacy and Safety of Endoscopic Ultrasound-Guided Retroperitoneal Fluid Collection Drainage with Novel Electrocautery-Enhanced Lumen-Apposing Metal Stents (with Video)
title_sort efficacy and safety of endoscopic ultrasound guided retroperitoneal fluid collection drainage with novel electrocautery enhanced lumen apposing metal stents with video
topic endosonography; pancreatic pseudocyst; stents; drainage
url http://gutnliver.org/journal/view.html?doi=10.5009/gnl240452
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