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 Table of Contents  
IMAGES AND VIDEOS
Year : 2018  |  Volume : 7  |  Issue : 5  |  Page : 347-348

EUS-guided drainage of pancreatic fluid collection with a Hot AXIOS stent in a patient with pancreatitis following distal pancreatectomy (with video)


1 Department of Gastroenterology, 306th Hospital of PLA, Beijing, China
2 Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA, USA
3 Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China

Date of Submission17-Feb-2017
Date of Acceptance03-Jul-2017
Date of Web Publication28-May-2018

Correspondence Address:
Dr. Qiang Cai
Department of Medicine, Division of Digestive Diseases, Emory University School of Medicine, Atlanta, GA
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/eus.eus_55_17

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How to cite this article:
Li L, Cristofaro S, Qu C, Liang S, Li X, Cai Q. EUS-guided drainage of pancreatic fluid collection with a Hot AXIOS stent in a patient with pancreatitis following distal pancreatectomy (with video). Endosc Ultrasound 2018;7:347-8

How to cite this URL:
Li L, Cristofaro S, Qu C, Liang S, Li X, Cai Q. EUS-guided drainage of pancreatic fluid collection with a Hot AXIOS stent in a patient with pancreatitis following distal pancreatectomy (with video). Endosc Ultrasound [serial online] 2018 [cited 2019 Nov 12];7:347-8. Available from: http://www.eusjournal.com/text.asp?2018/7/5/347/233429

The Hot AXIOS lumen-apposing stent (Xlumena Inc., Mountain View, CA, USA) is a novel double-flanged or “barbell-shaped,” covered, self-expanding metal stent that can be an efficient tool for the drainage of pancreatic fluid collection (PFC), which is mostly caused by gallstone disease, or alcoholic, idiopathic, or chronic pancreatitis.[1],[2],[3],[4],[5] Herein, we present a case of successful PFC drainage in a patient with pancreatitis following distal pancreatectomy [Video 1].




A 59-year-old woman presented with epigastric pain and nausea. She was diagnosed with pancreatitis 4 months after undergoing a distal pancreatectomy and splenectomy because of pancreatic cancer. An upper ultrasound revealed a normal esophagus. An extrinsic compression was found in the body of the stomach and antrum, along with hypertensive portal gastropathy throughout the stomach. A very careful examination performed with a 7.5 MHz linear echoendoscope revealed a large oval pseudocyst in the body of the pancreas. The pseudocyst measured 120 mm along the long axis and was anechoic on ultrasound. A small amount of layering debris was observed near the bottom of the cyst. Cystogastrostomy was performed with a 15 mm × 10 mm cautery-enhanced lumen-apposing metal stent. Immediately after stent deployment, a copious amount of dark fluid, approximately 1000 ml, drained from the cyst. The stent remained in an excellent position along the posterior wall of the body of the stomach. No unexpected events occurred. Sixty days later, the metal stent was removed using a snare, without difficulty. The pre- and post-drainage computed tomography images are shown in [Figure 1].
Figure 1: Computed tomography images obtained before and after drainage. (a) Large cyst before cystogastrostomy. (b) Stent is still in place, and the cyst size is decreased. (c) Stent was removed after cyst resolution

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The findings of this case indicate that EUS-guided cystogastrostomy with a Hot AXIOS stent is safe and effective in the setting of pancreatitis associated with pancreatic surgery.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has provided consent for submission of her images and other clinical information required for publication in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity but anonymity cannot be guaranteed.

Financial support and sponsorship

None.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Itoi T, Binmoeller KF, Shah J, et al. Clinical evaluation of a novel lumenapposing metal stent for endosonographyguided pancreatic pseudocyst and gallbladder drainage (with videos). Gastrointest Endosc 2012;75:8706.  Back to cited text no. 1
    
2.
Binmoeller KF, Smith I, Gaidhane M, et al. Akit for EUSguided access and drainage of pancreatic pseudocysts: Efficacy in a porcine model. Endosc Ultrasound 2012;1:13742.  Back to cited text no. 2
    
3.
Shah RJ, Shah JN, Waxman I, et al. Safety and efficacy of endoscopic ultrasoundguided drainage of pancreatic fluid collections with lumenapposing covered selfexpanding metal stents. Clin Gastroenterol Hepatol 2015;13:74752.  Back to cited text no. 3
    
4.
Rinninella E, Kunda R, Dollhopf M, et al. EUSguided drainage of pancreatic fluid collections using a novel lumenapposing metal stent on an electrocauteryenhanced delivery system: A large retrospective study (with video). Gastrointest Endosc 2015;82:103946.  Back to cited text no. 4
    
5.
Patil R, Ona MA, Papafragkakis C, et al. Endoscopic ultrasoundguided placement of AXIOS stent for drainage of pancreatic fluid collections. Ann Gastroenterol 2016;29:16873.  Back to cited text no. 5
    


    Figures

  [Figure 1]


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