Gastroenterology and Endoscopy Unit, Forlì-Cesena Hospitals, AUSL Romagna, Forlì, 47121, Italy.
Section of Gastroenterology, Department of Medical Sciences, University of Foggia, Foggia, 71100, Italy.
Dig Liver Dis. 2024 Jan;56(1):159-169. doi: 10.1016/j.dld.2023.07.012. Epub 2023 Jul 28.
The new dedicated stents for endoscopic ultrasound (EUS)-guided transluminal drainage of peri‑pancreatic fluid collections (PFCs) demonstrated optimal efficacy and safety profiles.
This study aimed to evaluate the safety, technical and clinical success, and recurrence rate of PFCs drained with Lumen Apposing Metal Stent (LAMS) or Bi-Flanged Metal Stent (BFMS).
Data from a multicenter series of PFCs treated with LAMS or BFMS at 30 Italian centers during a 5-year period were retrieved. The rate of adverse events (AEs), technical success, clinical success, PFC recurrence were evaluated. To overcome biases, a 1-to-1 match was created using propensity score analysis.
Out of 476 patients, 386 were treated with LAMS and 90 with BFMS, with a median follow-up of 290 days (95% CI 244 to 361). Using propensity score matching, 84 patients were assigned to each group. The incidence of AEs did not differ between the two stents (13.1% versus 15.5%, p = 0.29), mainly bleeding or recurrence rate (4.7% versus 3.5%, p = 1). Technical and clinical success in the BFMS and LAMS groups were 92% versus 95% (p = 0.36) and 91% versus 94% (p = 0.64), respectively.
Our study demonstrates that LAMS and BFMS have comparable safety profiles with similar technical and clinical success rates for EUS-guided PFC drainage.
新型内镜超声 (EUS) 引导下经腔透壁引流胰腺周围液体积聚 (PFC) 的专用支架显示出最佳的疗效和安全性。
本研究旨在评估 Lumen Apposing Metal Stent (LAMS) 或 Bi-Flanged Metal Stent (BFMS) 引流 PFC 的安全性、技术和临床成功率以及复发率。
回顾了意大利 30 家中心在 5 年期间使用 LAMS 或 BFMS 治疗 PFC 的多中心系列数据。评估了不良事件 (AE) 的发生率、技术成功率、临床成功率、PFC 复发率。为了克服偏倚,使用倾向评分分析创建了 1:1 匹配。
476 例患者中,386 例接受 LAMS 治疗,90 例接受 BFMS 治疗,中位随访时间为 290 天 (95%CI 244 至 361)。使用倾向评分匹配,每组分配 84 例患者。两种支架的 AE 发生率无差异 (13.1% 与 15.5%,p=0.29),主要是出血或复发率 (4.7% 与 3.5%,p=1)。BFMS 和 LAMS 组的技术和临床成功率分别为 92%和 95% (p=0.36)和 91%和 94% (p=0.64)。
我们的研究表明,LAMS 和 BFMS 具有相似的安全性,在 EUS 引导的 PFC 引流方面具有相似的技术和临床成功率。