Li Peng, Zhang Zheng, Wang Sheng, Jin Zhendong, Du Yiqi, Yang Aiming, Feng Yunlu, Zou Xiaoping, Wang Lei, Wang Xiaoyan, Tian Li, Zhou Pinghong, Zhang Yiqun, Liu Jun, Ding Zhen, Zhang Junwen, Yang Jian, Sun Siyu, Zhang Shutian
Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.
Endosc Ultrasound. 2023 Mar-Apr;12(2):259-265. doi: 10.4103/EUS-D-22-00058.
The Hot AXIOS system, which features a cautery-enhanced lumen-apposing metal stent, facilitates EUS-guided transmural drainage of pancreatic fluid collection (PFC). We aimed to evaluate the safety and efficacy of stents in a multicenter Chinese cohort.
Thirty patients from nine centers with a single pancreatic pseudocyst (PP) or walled-off necrosis (WON) who underwent EUS-guided transgastric or transduodenal drainage with the novel stent were prospectively enrolled.
We included 15 (50%) patients with PPs and 15 (50%) with WONs. The mean diameter of the PFCs was 11.06 ± 3.56 cm. Stent placement was technically successful in all patients (100%), whereas clinical success was achieved in 93.3% of patients (28/30). Clinical success was defined as the alleviation of clinical symptoms combined with at least a 50% reduction in PFC diameter within 60 days after surgery. 73.3% (22/30) of AXIOS stents were removed after reaching clinical success in the 1 month of follow-up. A total of 14 (46.7%) PFC-associated infections occurred (4 pre- and 10 postoperation), which recovered within 1 week after treatment. Other complications included three (10%) partially or fully blocked stents and two (6.7%) stent migrations. Regarding the fully opened stent without blocking, complete remission of PFCs within 1 month was independently predicted by a previous pancreatitis attack > 6 months prior (adjusted odds ratio: 11.143; 95% confidence interval: 1.108-112.012; P = 0.041).
EUS-guided drainage of PFCs using the Hot AXIOS system is safe and efficient. Regarding completely patent stents, a previous pancreatitis attack > 6 months prior predicts a greater chance of achieving 100% remission of PFCs within 1 month of AXIOS treatment.
Hot AXIOS系统以带有烧灼增强的管腔贴壁金属支架为特色，有助于内镜超声引导下胰腺液体积聚（PFC）的经壁引流。我们旨在评估在中国多中心队列中使用该支架的安全性和有效性。
前瞻性纳入了来自9个中心的30例患者，这些患者患有单一胰腺假性囊肿（PP）或包裹性坏死（WON），并接受了内镜超声引导下经胃或经十二指肠使用新型支架的引流术。
我们纳入了15例（50%）PP患者和15例（50%）WON患者。PFC的平均直径为11.06±3.56厘米。所有患者（100%）的支架置入在技术上均成功，而93.3%的患者（28/30）获得了临床成功。临床成功定义为临床症状缓解且术后60天内PFC直径至少缩小50%。在随访的1个月内，达到临床成功后，73.3%（22/30）的AXIOS支架被取出。总共发生了14例（46.7%）与PFC相关的感染（4例术前和10例术后），治疗后1周内恢复。其他并发症包括3例（10%）部分或完全堵塞的支架和2例（6.7%）支架移位。对于未堵塞的完全打开的支架，术前胰腺炎发作超过6个月可独立预测PFC在1个月内完全缓解（调整后的优势比：11.143；95%置信区间：1.108 - 112.012；P = 0.041）。
使用Hot AXIOS系统进行内镜超声引导下PFC引流是安全且有效的。对于完全通畅的支架，术前胰腺炎发作超过6个月预示着在AXIOS治疗1个月内PFC实现100%缓解的可能性更大。
