Clinical outcomes of EUS-guided transluminal drainage with a novel lumen-apposing metal stent for postoperative pancreatic fluid collection after pancreatic surgery

ABSTRACT

Background and Aims

Endoscopic ultrasound-guided transluminal drainage (EUS-TD) has been increasingly used for the treatment of postoperative pancreatic fluid collections (POPFCs). A novel lumen-apposing metal stent (LAMS) has been recently developed and used for the drainage of POPFCs. This study aimed to evaluate the efficacy and safety of a novel LAMS in patients with POPFCs.

Methods

A total of 47 patients with symptomatic POPFCs who underwent EUS-TD with a novel LAMS (Niti-S SPAXUS) between April 2019 and July 2020 were included in this study. Clinical outcomes, including technical success, clinical success, and adverse events, were retrospectively evaluated.

Results

EUS-TD was technically successful in 41 of the 47 total patients (87.2%). Clinical success was achieved in 37 of 41 patients (90.2%). The mean procedure time was 13.7 ± 3.5 min. The mean POPFC size was 59 ± 18.9 mm. The mean time interval from surgery to EUS-TD was 24.2 ± 37.6 days. Five patients experienced 6 procedural adverse events (12.8%), including POPFC infection (n = 4, 8.5%) and distal stent migration (n = 2, 4.3%). The 4 patients with POPFC infection underwent additional endoscopic interventions. Of the 2 patients with stent migration, one patient underwent laparoscopic exploration and surgical extraction of the stent. One patient (2.1%) experienced POPFC recurrence, which was managed with percutaneous drainage.

Conclusions

EUS-TD for symptomatic POPFCs with a novel LAMS is technically feasible and effective, with an acceptable adverse event rate. Further larger-scale prospective studies are required to confirm the findings of this study.