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ORIGINAL ARTICLE
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Placement of lumen-apposing metal stents to drain pseudocysts and walled-off pancreatic necrosis can be safely performed on an outpatient basis: A multicenter study


1 Division of Gastroenterology and Hepatology, University of Utah Hospital, Salt Lake City, UT, USA
2 Division of Gastroenterology, California Pacific Medical Center, San Francisco, CA, USA
3 Department of Gastroenterology, Borland-Groover Clinic, Jacksonville, FL, USA
4 Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA

Correspondence Address:
Ali A Siddiqui,
Thomas Jefferson University, 132 S. 10th Street, Main Building, Philadelphia, PA 19107
USA
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eus.eus_30_17

PMID: 29770780

Backgrounds and Objectives: No study on the use of lumen-apposing fully covered self-expanding metal stent(LAMS) to drain pancreatic fluid collections(PFCs) has evaluated outcomes of patients in the outpatient setting. The objective of this multicenter study was to evaluate the clinical outcomes, success rate, and adverse events of the LAMS for endoscopic ultrasound(EUS)-guided transmural drainage of patients with symptomatic PFCs on an inpatient versus an outpatient basis. Methods: This was a multicenter, retrospective study conducted at 4 tertiary care centers. Results: We identified eighty patients with PFCs in whom EUS-guided transmural drainage using the LAMS was performed. The mean age of the patients was 53.1 years old. Mean size of the PFC was 11.8±5.1cm. Atotal of 33patients had PFCs drained in an outpatient setting while 47patients underwent PFC drainage as inpatients. The overall technical success(ability to access and drain a PFC by placement of transmural stents) was 98.7%(79patients). There was no statistically significant difference in the technical success rate between the inpatient and outpatient groups(100% vs. 98%, respectively, P =1). There was no significant difference in resolution of PFCs in the inpatient and outpatient groups(91% vs. 87% respectively; P =1). The number of procedures required for PFC resolution was significantly lower in the inpatient group as compared to the outpatients (2.3vs. 3.1 respectively, P =0.025). Procedure-related adverse events were significantly lower in the inpatient group compared to the outpatient group(P<0.01). There was no significant difference in the 2 groups in terms of development of adverse events requiring endoscopic reintervention within 30days of initial stent placement(P=0.69). Conclusion: This study shows that LAMS placement for PFCs can be performed safely on an outpatient basis with overall technical and clinical outcomes that are comparable to those seen in inpatients.


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    -  Adler DG
    -  Shah J
    -  Nieto J
    -  Binmoeller K
    -  Bhat Y
    -  Taylor LJ
    -  Siddiqui AA
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