Shin Ho Cheol, Cho Chang Min, Jung Min Kyu, Yeo Seong Jae
Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea.
Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea.
Clin Endosc. 2019 Jul;52(4):353-359. doi: 10.5946/ce.2018.154. Epub 2019 Mar 13.
BACKGROUND/AIMS: Endoscopic ultrasound (EUS)-guided transmural drainage for peripancreatic fluid collections (PFCs) has gained wide acceptance as a nonsurgical intervention. Although a lumen-apposing metal stent (LAMS) was recently introduced, there are few data comparing the clinical outcomes between LAMS and plastic stent (PS) drainage.
Endoscopy databases of all patients who had undergone EUS-guided drainage for PFCs were searched and the clinical outcomes of EUS-guided drainage according to stent-type used were compared.
A total of 27 patients (median age, 56 years) with PFCs underwent EUS-guided transmural drainage between January 2011 and December 2017. Of these, 17 underwent PS placement and 10 underwent LAMS placement. There was no significant difference in the technical success rate between the 2 groups (94.1% vs. 100%, p=1.0). Procedure time was shorter in the LAMS group compared to that in the PS group (10.6±2.5 min vs. 21.4±9.5 min, p=0.002). Among subjects with clinical success, recurrence of PFC after stent removal occurred in 5 of 12 patients with PS and 4 of 10 with LAMS, without statistical difference (41.7% vs. 40.0%, p=1.0).
Although our study showed similar clinical outcomes for LAMS and PS, further prospective trials are required to validate the superiority of LAMS.
背景/目的:内镜超声(EUS)引导下经壁引流治疗胰周液体积聚(PFCs)作为一种非手术干预方法已被广泛接受。尽管最近引入了管腔对合金属支架(LAMS),但比较LAMS和塑料支架(PS)引流临床结局的数据较少。
检索所有接受EUS引导下PFCs引流患者的内镜数据库,并比较根据所用支架类型进行EUS引导下引流的临床结局。
2011年1月至2017年12月期间,共有27例(中位年龄56岁)PFCs患者接受了EUS引导下经壁引流。其中,17例放置了PS,10例放置了LAMS。两组技术成功率无显著差异(94.1%对100%,p=1.0)。LAMS组的操作时间比PS组短(10.6±2.5分钟对21.4±9.5分钟,p=0.002)。在临床成功的患者中,PS组12例中有5例在支架取出后PFC复发,LAMS组10例中有4例复发,无统计学差异(41.7%对40.0%,p=1.0)。
尽管我们的研究显示LAMS和PS的临床结局相似,但仍需要进一步的前瞻性试验来验证LAMS的优越性。