Outcomes of a single-step endoscopic ultrasound-guided drainage of pancreatic-fluid collections using an electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent with and without fluoroscopy
Abstract Background Fluoroscopy is often used during the endoscopic drainage of pancreatic-fluid collections (PFCs). An electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent (ELAMS) facilitates a single-step procedure and may avoid the need for fluoroscopy. This study compares t...
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| Veröffentlicht in: | Gastroenterology report 2020-12, Vol.8 (6), p.425-430 |
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| creator | Olaiya, Babatunde Mekaroonkamol, Parit Li, Bai-Wen Massaad, Julia Vachaparambil, Cicily T Xu, Jennifer Lamm, Vladamir Luo, Hui Shen, Shan-Shan Chen, Hui-Min Keilin, Steve Willingham, Field F Cai, Qiang |
| description | Abstract
Background
Fluoroscopy is often used during the endoscopic drainage of pancreatic-fluid collections (PFCs). An electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent (ELAMS) facilitates a single-step procedure and may avoid the need for fluoroscopy. This study compares the treatment outcomes using ELAMS with and without fluoroscopy.
Methods
Patients with PFCs who had cystogastrostomy from January 2014 to February 2017 were enrolled. Two groups were studied based on fluoroscopy use. Technical success was defined as uneventful insertion of ELAMS at time of procedure. Clinical success was defined as (i) clinical resolution of symptoms after the procedure and (ii) >75% reduction in cyst size on computed tomography 8 weeks after stent placement. Adverse events including bleeding, stent migration, and infection were recorded.
Results
A total of 21 patients (13 males) had PFCs drainage with ELAMS in the study period. The mean age was 51.6 ± 14.2 years. Thirteen patients had walled-off necrosis while eight had a pancreatic pseudocyst. The mean size of the PFCs was 11.3 ± 3.3 cm. Fluoroscopy was used in seven cases (33%) and was associated with a longer procedure time compared to non-fluoroscopy (43.1 ± 10.4 vs 33.3 ± 10.5 min, P = 0.025). This association was independent of the size, location, or type of PFCs. Fluoroscopy had no effect on the technical success rates. In fluoroless procedures, the clinical resolution was 91% as compared to 71% in fluoroscopy procedures (P = 0.52) and the radiologic resolution was 57% as compared to 71% in fluoroscopy procedures (P = 0. 65). Three cases of stent migration/displacement occurred in the fluoroless procedures.
Conclusions
ELAMS may avoid the need for fluoroscopy during cystogastrostomy. Procedures without fluoroscopy were significantly shorter and fluoroscopy use had no impact on the technical or clinical success rates. |
| doi_str_mv | 10.1093/gastro/goaa020 |
| format | Article |
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Background
Fluoroscopy is often used during the endoscopic drainage of pancreatic-fluid collections (PFCs). An electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent (ELAMS) facilitates a single-step procedure and may avoid the need for fluoroscopy. This study compares the treatment outcomes using ELAMS with and without fluoroscopy.
Methods
Patients with PFCs who had cystogastrostomy from January 2014 to February 2017 were enrolled. Two groups were studied based on fluoroscopy use. Technical success was defined as uneventful insertion of ELAMS at time of procedure. Clinical success was defined as (i) clinical resolution of symptoms after the procedure and (ii) >75% reduction in cyst size on computed tomography 8 weeks after stent placement. Adverse events including bleeding, stent migration, and infection were recorded.
Results
A total of 21 patients (13 males) had PFCs drainage with ELAMS in the study period. The mean age was 51.6 ± 14.2 years. Thirteen patients had walled-off necrosis while eight had a pancreatic pseudocyst. The mean size of the PFCs was 11.3 ± 3.3 cm. Fluoroscopy was used in seven cases (33%) and was associated with a longer procedure time compared to non-fluoroscopy (43.1 ± 10.4 vs 33.3 ± 10.5 min, P = 0.025). This association was independent of the size, location, or type of PFCs. Fluoroscopy had no effect on the technical success rates. In fluoroless procedures, the clinical resolution was 91% as compared to 71% in fluoroscopy procedures (P = 0.52) and the radiologic resolution was 57% as compared to 71% in fluoroscopy procedures (P = 0. 65). Three cases of stent migration/displacement occurred in the fluoroless procedures.
Conclusions
ELAMS may avoid the need for fluoroscopy during cystogastrostomy. Procedures without fluoroscopy were significantly shorter and fluoroscopy use had no impact on the technical or clinical success rates.</description><identifier>ISSN: 2052-0034</identifier><identifier>EISSN: 2052-0034</identifier><identifier>DOI: 10.1093/gastro/goaa020</identifier><identifier>PMID: 33442474</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Original</subject><ispartof>Gastroenterology report, 2020-12, Vol.8 (6), p.425-430</ispartof><rights>The Author(s) 2020. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-sen University 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-sen University.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-d3e135d407181fae64c24c4d2a69cdffebc8185c65ab614acc824ba83562b4813</citedby><cites>FETCH-LOGICAL-c424t-d3e135d407181fae64c24c4d2a69cdffebc8185c65ab614acc824ba83562b4813</cites><orcidid>0000-0002-7071-3001</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793111/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7793111/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,1599,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33442474$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Olaiya, Babatunde</creatorcontrib><creatorcontrib>Mekaroonkamol, Parit</creatorcontrib><creatorcontrib>Li, Bai-Wen</creatorcontrib><creatorcontrib>Massaad, Julia</creatorcontrib><creatorcontrib>Vachaparambil, Cicily T</creatorcontrib><creatorcontrib>Xu, Jennifer</creatorcontrib><creatorcontrib>Lamm, Vladamir</creatorcontrib><creatorcontrib>Luo, Hui</creatorcontrib><creatorcontrib>Shen, Shan-Shan</creatorcontrib><creatorcontrib>Chen, Hui-Min</creatorcontrib><creatorcontrib>Keilin, Steve</creatorcontrib><creatorcontrib>Willingham, Field F</creatorcontrib><creatorcontrib>Cai, Qiang</creatorcontrib><title>Outcomes of a single-step endoscopic ultrasound-guided drainage of pancreatic-fluid collections using an electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent with and without fluoroscopy</title><title>Gastroenterology report</title><addtitle>Gastroenterol Rep (Oxf)</addtitle><description>Abstract
Background
Fluoroscopy is often used during the endoscopic drainage of pancreatic-fluid collections (PFCs). An electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent (ELAMS) facilitates a single-step procedure and may avoid the need for fluoroscopy. This study compares the treatment outcomes using ELAMS with and without fluoroscopy.
Methods
Patients with PFCs who had cystogastrostomy from January 2014 to February 2017 were enrolled. Two groups were studied based on fluoroscopy use. Technical success was defined as uneventful insertion of ELAMS at time of procedure. Clinical success was defined as (i) clinical resolution of symptoms after the procedure and (ii) >75% reduction in cyst size on computed tomography 8 weeks after stent placement. Adverse events including bleeding, stent migration, and infection were recorded.
Results
A total of 21 patients (13 males) had PFCs drainage with ELAMS in the study period. The mean age was 51.6 ± 14.2 years. Thirteen patients had walled-off necrosis while eight had a pancreatic pseudocyst. The mean size of the PFCs was 11.3 ± 3.3 cm. Fluoroscopy was used in seven cases (33%) and was associated with a longer procedure time compared to non-fluoroscopy (43.1 ± 10.4 vs 33.3 ± 10.5 min, P = 0.025). This association was independent of the size, location, or type of PFCs. Fluoroscopy had no effect on the technical success rates. In fluoroless procedures, the clinical resolution was 91% as compared to 71% in fluoroscopy procedures (P = 0.52) and the radiologic resolution was 57% as compared to 71% in fluoroscopy procedures (P = 0. 65). Three cases of stent migration/displacement occurred in the fluoroless procedures.
Conclusions
ELAMS may avoid the need for fluoroscopy during cystogastrostomy. Procedures without fluoroscopy were significantly shorter and fluoroscopy use had no impact on the technical or clinical success rates.</description><subject>Original</subject><issn>2052-0034</issn><issn>2052-0034</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqFkk1v1DAQhiMEolXplSPyESTc2rGzyV6QUAUtUqVe4BxN7EnWyLGDP6D7L_lJON2lKidOHnneeeYdzVTVa84uONuKywliCv5y8gCsZs-q05o1NWVMyOdP4pPqPMbvjDHO2rrhzcvqRAgpa9nK0-r3XU7KzxiJHwmQaNxkkcaEC0GnfVR-MYpkmwJEn52mUzYaNdEBjIMJ17IFnAoIySg62pImyluLKhnvIskrkoAjuH4FryAnDHuKblfKcBXDvQFLbJ7RUVgWv1a8JxHtSPG-wPVKmDEVUTHmEvll0q4g9UPgcyKlrQ8PZvevqhcj2Ijnx_es-vb509erG3p7d_3l6uMtVWXyRLVALhotWcs7PgJupKqlkrqGzVbpccRBdbxr1KaBYcMlKNXVcoBONJt6kB0XZ9WHA3fJw4xaFV8BbL8EM0PY9x5M_2_GmV0_-Z99224F5yvg7REQ_I-MMfWziQqtBYc-x77sp2OibYUo0ouDVJUhY8DxsQ1n_XoJ_eES-uMllII3T809yv_uvQjeHQQ-L_-D_QEiUsh0</recordid><startdate>20201201</startdate><enddate>20201201</enddate><creator>Olaiya, Babatunde</creator><creator>Mekaroonkamol, Parit</creator><creator>Li, Bai-Wen</creator><creator>Massaad, Julia</creator><creator>Vachaparambil, Cicily T</creator><creator>Xu, Jennifer</creator><creator>Lamm, Vladamir</creator><creator>Luo, Hui</creator><creator>Shen, Shan-Shan</creator><creator>Chen, Hui-Min</creator><creator>Keilin, Steve</creator><creator>Willingham, Field F</creator><creator>Cai, Qiang</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7071-3001</orcidid></search><sort><creationdate>20201201</creationdate><title>Outcomes of a single-step endoscopic ultrasound-guided drainage of pancreatic-fluid collections using an electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent with and without fluoroscopy</title><author>Olaiya, Babatunde ; Mekaroonkamol, Parit ; Li, Bai-Wen ; Massaad, Julia ; Vachaparambil, Cicily T ; Xu, Jennifer ; Lamm, Vladamir ; Luo, Hui ; Shen, Shan-Shan ; Chen, Hui-Min ; Keilin, Steve ; Willingham, Field F ; Cai, Qiang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c424t-d3e135d407181fae64c24c4d2a69cdffebc8185c65ab614acc824ba83562b4813</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Original</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Olaiya, Babatunde</creatorcontrib><creatorcontrib>Mekaroonkamol, Parit</creatorcontrib><creatorcontrib>Li, Bai-Wen</creatorcontrib><creatorcontrib>Massaad, Julia</creatorcontrib><creatorcontrib>Vachaparambil, Cicily T</creatorcontrib><creatorcontrib>Xu, Jennifer</creatorcontrib><creatorcontrib>Lamm, Vladamir</creatorcontrib><creatorcontrib>Luo, Hui</creatorcontrib><creatorcontrib>Shen, Shan-Shan</creatorcontrib><creatorcontrib>Chen, Hui-Min</creatorcontrib><creatorcontrib>Keilin, Steve</creatorcontrib><creatorcontrib>Willingham, Field F</creatorcontrib><creatorcontrib>Cai, Qiang</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Gastroenterology report</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Olaiya, Babatunde</au><au>Mekaroonkamol, Parit</au><au>Li, Bai-Wen</au><au>Massaad, Julia</au><au>Vachaparambil, Cicily T</au><au>Xu, Jennifer</au><au>Lamm, Vladamir</au><au>Luo, Hui</au><au>Shen, Shan-Shan</au><au>Chen, Hui-Min</au><au>Keilin, Steve</au><au>Willingham, Field F</au><au>Cai, Qiang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of a single-step endoscopic ultrasound-guided drainage of pancreatic-fluid collections using an electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent with and without fluoroscopy</atitle><jtitle>Gastroenterology report</jtitle><addtitle>Gastroenterol Rep (Oxf)</addtitle><date>2020-12-01</date><risdate>2020</risdate><volume>8</volume><issue>6</issue><spage>425</spage><epage>430</epage><pages>425-430</pages><issn>2052-0034</issn><eissn>2052-0034</eissn><abstract>Abstract
Background
Fluoroscopy is often used during the endoscopic drainage of pancreatic-fluid collections (PFCs). An electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent (ELAMS) facilitates a single-step procedure and may avoid the need for fluoroscopy. This study compares the treatment outcomes using ELAMS with and without fluoroscopy.
Methods
Patients with PFCs who had cystogastrostomy from January 2014 to February 2017 were enrolled. Two groups were studied based on fluoroscopy use. Technical success was defined as uneventful insertion of ELAMS at time of procedure. Clinical success was defined as (i) clinical resolution of symptoms after the procedure and (ii) >75% reduction in cyst size on computed tomography 8 weeks after stent placement. Adverse events including bleeding, stent migration, and infection were recorded.
Results
A total of 21 patients (13 males) had PFCs drainage with ELAMS in the study period. The mean age was 51.6 ± 14.2 years. Thirteen patients had walled-off necrosis while eight had a pancreatic pseudocyst. The mean size of the PFCs was 11.3 ± 3.3 cm. Fluoroscopy was used in seven cases (33%) and was associated with a longer procedure time compared to non-fluoroscopy (43.1 ± 10.4 vs 33.3 ± 10.5 min, P = 0.025). This association was independent of the size, location, or type of PFCs. Fluoroscopy had no effect on the technical success rates. In fluoroless procedures, the clinical resolution was 91% as compared to 71% in fluoroscopy procedures (P = 0.52) and the radiologic resolution was 57% as compared to 71% in fluoroscopy procedures (P = 0. 65). Three cases of stent migration/displacement occurred in the fluoroless procedures.
Conclusions
ELAMS may avoid the need for fluoroscopy during cystogastrostomy. Procedures without fluoroscopy were significantly shorter and fluoroscopy use had no impact on the technical or clinical success rates.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>33442474</pmid><doi>10.1093/gastro/goaa020</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7071-3001</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Original |
| title | Outcomes of a single-step endoscopic ultrasound-guided drainage of pancreatic-fluid collections using an electrocautery-enhanced coaxial lumen-apposing, self-expanding metal stent with and without fluoroscopy |
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