Symptomatic Pancreatic Pseudocysts Research Articles

Surgical and Endoscopic Intervention for Chronic Pancreatitis in Children: The Kings College Hospital Experience.

Paediatric chronic pancreatitis (CP) is a rare and debilitating pathology that often requires invasive diagnostics and therapeutic interventions either to address a primary cause such as a pancreaticobiliary malunion or to deal with secondary complications such as chronic pain. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound (EUS) are two endoscopic modalities that have an established diagnostic role in paediatric CP, and their therapeutic utilisation is increasing in popularity. Surgical decompression of the obstructed and dilated pancreatic duct plays a role in alleviating pancreatic duct hypertension, a common association in CP. Surgery equally has a role in certain anatomical abnormalities of the pancreaticobiliary draining system, or occasionally in some CP complications such as drainage of a symptomatic pancreatic pseudocyst.

PSEUDO-KYSTE DU PANCREAS CHEZ LA PERSONNE AGEE

Introduction: Pancreatic pseudocysts (PKP) are fluid collections without their own epithelium, developed at the expense of or in contact with the pancreas, containing pure pancreatic juice or mixed with necrotic debris, following pancreatitis or trauma, or of undetermined cause. Treatment of PKP usually requires drainage. We discuss the diagnostic and therapeutic aspects of a case of pseudocyst of the pancreas drained by conventional surgery in an elderly patient with a good post-operative course. Observation: We admitted an 80-years-old patient with epigastric abdominal mass, pain, physical asthenia and anorexia evolving for 1 year. She had no previous medical history. Examination revealed a painful epigastric abdominal mass, more or less mobile in relation to the deep plane, with a smooth surface and irregular, matt edges. Pelvic touch was unremarkable. CT scan showed a large intra-abdominal cystic mass (pancreatic cyst? mesenteric cyst?). Biology revealed anemia and hyperleukocytosis. After laparotomy, we found a voluminous, firm cystic mass, about 10x5x8 cm in size, at the expense of the body of the pancreas. We proceeded to internal drainage of the cyst by retrogastric cysto gastrostomy according to JEDLICKA. The patient was followed up for one year without any particularities. Conclusion: In our case, a symptomatic pancreatic pseudocyst was drained by surgical retrogastric cystogastrostomy with a favorable outcome. The management of pancreatic pseudocysts requires a multidisciplinary approach and an adequate technical platform.

Is Cystogastrostomy a Definitive Operation for Pancreatitis Associated Pancreatic Fluid Collections?

Pancreatic-enteric drainage procedures have become standard therapy for symptomatic pancreatic pseudocysts and walled-off pancreatic necrosis. The need for pancreatic resection after cyst-enteric drainage procedure in the event of recurrence is not well studied. This study aimed to quantify the percentage of patients requiring resection due to recurrence after surgical cystogastrostomy and identify predictors of drainage failure. A single-institution retrospective review was conducted to identify all patients undergoing surgical cystogastrostomy between 2012 and 2020. Demographic, disease, and treatment characteristics were identified. Failure of surgical drainage was defined as the need for subsequent pancreatic resection due to recurrence. Characteristics between failure and nonfailure groups were compared with identifying predictors of treatment failure. Twenty-four cystogastrostomies were performed during the study period. Three patients (12.5%) required a subsequent distal pancreatectomy after surgical drainage. There was no difference in comorbidities between drainage alone and failure of drainage groups. Mean cyst size seemed to be larger in patients that underwent drainage alone versus those that needed subsequent resection (15.2 vs 10.3cm, P =0.05). Estimated blood loss at initial operation was similar between groups (126 vs 166mL, P =0.36). Surgical pancreatic drainage was successful in the initial management of pancreatic fluid collections. We did not identify any predictors of failure of initial drainage. There was a trend suggesting smaller cyst size may be associated with cystgastrostomy failure. Resection with distal pancreatectomy for walled-off pancreatic necrosis and pancreatic pseudocysts can be reserved for cases of failure of drainage.

A clinical study on pseudo-cyst pancreas: Clinical presentation, surgical, and different modalities of treatment and outcome

BACKGROUND: Pancreatic pseudocysts are walled-off collections of necrotic tissue, old blood, and secretions that are encapsulated. Collections lack a real capsule, and the cyst wall is composed of nearby viscera such as the stomach and/or colon. Pseudocysts are the most frequent side effects of both acute and chronic pancreatic inflammation. In our prospective interventional study, 25 patients with symptomatic pancreatic pseudocysts were included. Majority of patients were belonged to the age group of 31–40 years, with males being more common. The most common cause is alcoholism, followed by idiopathy. Most of them presented with pain abdomen as the chief complaint. Ultrasonography (USG) and computed tomography (CT) of the abdomen were found to be accurate investigations. Acute pseudocysts were managed conservatively, whereas infected cysts necessitated external drainage. In the majority of cases, anastomoses of the cyst to the nearby bowel, either cystogastrostomy or cystojejunostomy, were performed with good results.METHODS: Study design - Hospital-based prospective interventional study. Sample size - 25. The study was the prospective interventional study, conducted at Basaweshwar Hospital from July 2020 to August 2022, 25 patients with symptomatic pancreatic pseudocysts included. Patients had baseline tests as well as specific tests such as serum amylase and serum lipase. All patients underwent USG and CT Abdomen to determine the morphology, and treatment was planned accordingly.RESULTS: A total of 25 patients were included in the study. Out of 25 patients, the cause of pancreatic pseudocyst was found to be alcohol consumption in 80% and other causes in 14%. The common indication for intervention was persistent pain (60%) The type of intervention was chosen based on the physical state of the patient as well as the location and type of the pseudocyst. USG-guided drainage was done in 14% and surgical drainage procedure-cystogastrostomy - 36% and cystojejunostomy 26%.CONCLUSION: The most common cystic lesion of the pancreas is the pancreatic pseudocyst. The disease was common in the age group of 31–50 years and was seen predominantly in males. The most common cause is alcoholism, followed by idiopathy. Pain in the abdomen with tenderness is a common presentation. The most useful tests were an ultrasound and a CT scan. Acute pseudocysts were managed conservatively, while infected cysts required external drainage. In the majority of cases, anastomosis of the cyst to the nearby bowel, either by cystogastrostomy or cystojejunostomy, was performed with good results.

Endoscopic Cystogastrostomy in Children with Symptomatic Pancreatic Pseudocyst

Endoscopic Cystogastrostomy in Children with Symptomatic Pancreatic Pseudocyst

Supportive treatment during the periprocedural period of endoscopic treatment for pancreatic fluid collections: a critical review of current knowledge and future perspectives.

Pancreatic fluid collections (PFCs) commonly develop as complications of acute pancreatitis and ductal disruption due to chronic pancreatitis. In the revised Atlanta classification, PFCs were classified based on the presence of necrosis and duration following the onset of acute pancreatitis. Interventions are required in cases of symptomatic pancreatic pseudocysts or walled-off necrosis (WON). In the management of these PFCs, endoscopic ultrasound-guided transluminal drainage and subsequent direct endoscopic necrosectomy for WON are increasingly utilized as less invasive treatment modalities compared to surgical debridement. To date, researchers have focused predominantly on the technical aspects of endoscopic therapy for symptomatic PFCs. Given the poor physical condition of patients receiving endoscopic treatment for PFCs, systemic support may have a substantial impact on the short- and long-term outcomes of these patients. A multidisciplinary approach is required to improve the clinical outcomes of patients with infected PFCs and their associated comorbidities. However, non-interventional support during the periprocedural period of endoscopic treatment of PFCs has not been fully discussed, and there have been considerable variations in the selection of treatment options between endoscopists and centers. To address these unmet needs in the clinical management of PFCs and promote future research to improve the clinical outcomes, we conducted a review of the literature within a multicenter consortium of expert endoscopists with specific expertise in the endoscopic treatment of PFCs. In this review, we summarize the current evidence on non-interventional supportive care (e.g., continuous lavage, medications, nutritional support, and antimicrobials) and propose potential topics for future research.

Technical and Clinical Outcomes of Using a Single Wide-Caliber Double-Pigtail Stent for Endoscopic Ultrasound-Guided Pancreatic Pseudocyst Drainage: A Multicenter Prospective Study

Introduction: Endoscopic ultrasound (EUS)-guided pancreatic cysto-gastrostomy/duodenostomy is the current accepted practice for management of symptomatic pancreatic pseudocysts with insertion of two or more double-pigtail (DP) stents. There is no much work on the efficacy of using a single wide-caliber DP stent, aiming to decrease the time, complications, and accessories used in the procedure. Aim of the Work: The aim of this study was to assess technical and clinical outcomes of using a single wide-caliber DP stent in EUSguided pancreatic pseudocyst drainage. Methodology: This multicenter prospective study included 57 patients, from which the 35 patients with symptomatic pancreatic pseudocysts enrolled. Patients with cysts with multiple septations (7 cases) or cyst with >30% necrosis (8 cases) of the cyst content and patients with generalized ascites (4 cases) or patients with major comorbidities (3 cases) were excluded. Patients were followed up within 1 month and 6 months after stent placement to assess complete resolution or a decrease in the sizes of cysts with clinical symptomatic improvement. Results: From 57 patients, 35 patients (19 females/16 males, median age 40 years) with a symptomatic pancreatic pseudocyst were referred for EUS-guided drainage. All used stents were 10 Fr DP plastic stents. The median duration of the whole procedure was 16 min. Technical success was achieved in all cases. Clinical success was encountered in 32 patients (91.4%) without re-accumulation on follow-up. Minor adverse events were encountered in 3 patients (8.6%) including post-procedure abdominal pain (1 case) and fever (2 cases). Conclusion: We suggest that using a wide-caliber single-pigtail stent for EUS-guided cystogastrostomy is safe and effective with short procedure time, with reduced risks from the insertion of another stent(s).

Internal drainage of pancreatic pseudocyst following abdominal blunt trauma

Pancreatic pseudocyst is a well-recognized complication of acute pancreatitis, chronic pancreatitis and pancreatic trauma. Pancreatic trauma is the most common cause among children cases. The aim of this study is to describe the clinical presentation and management of symptomatic pancreatic pseudocyst in a series of 2 children following abdominal blunt trauma treated in our institution between January 2021 to August 2021. This was single-centre case series from our institution that is a tertiary referral hospital from January to August 2021. There were two patients between age 8–11 that diagnosed with pancreatic pseudocyst after blunt abdominal trauma, both of them underwent open internal drainage, specifically cystojejunostomy. All of 2 patients had a history of blunt abdominal trauma due to bicycle handlebar injury. Epigastric pain and abdominal mass were the main complaints. Amylase and lipase serum level were elevated and imaging diagnostic reveal pancreatic pseudocyst. Open cystojejunostomy were performed and the patient discharged from the hospital on day 7 and day 11 post operative, respectively, without any complication. Pancreatic pseudocyst although rare in children, can lead to a significant morbidity if not properly diagnosed and treated. Open internal drainage is still the procedure of choice in our institution.

Endoscopic Versus Laparoscopic Drainage of Pancreatic Pseudocysts: a Cost-effectiveness Analysis

BackgroundBoth endoscopic and laparoscopic interventions have a high therapeutic success rate in the management of symptomatic pancreatic pseudocysts; however, neither has been established as the gold standard. MethodsA decision tree analysis was performed to examine the costs and outcomes of intervening on pancreatic pseudocysts endoscopically versus laparoscopically. Within the model, a theoretical patient cohort was separated into two treatment arms: endoscopic drainage and laparoscopic drainage. Variables within the model were selected from the published literature. Medicare reimbursements rates (US$) were used to represent costs accumulated during a 3-month perioperative period. Effectiveness was characterized by quality-adjusted life-years (QALYs). A willingness-to-pay of $100,000 per 1 year of perfect health (1 QALY) gained was used as the cost-effectiveness threshold. The model was validated using one-way, two-way, and probabilistic sensitivity analysis. ResultsEndoscopic management of symptomatic pancreatic pseudocysts was the dominant strategy, producing 0.22 QALYs more while saving $23,976.37 in comparison to laparoscopic management. This result was further validated by one-way, two-way, and probabilistic sensitivity analysis. ConclusionsFor patients presenting with symptomatic pancreatic pseudocysts amenable to either endoscopic or laparoscopic management, endoscopic drainage should be considered first-line therapy.

Endoscopic ultrasound-guided drainage of peripancreatic fluid collections: What impacts treatment duration?

BackgroundPeripancreatic fluid collections (PFCs) are complications resulting from acute or chronic pancreatitis and require treatment in certain clinical conditions. The present study aimed to identify the factors influencing the duration of endoscopic ultrasound (EUS)-guided drainage of symptomatic pancreatic pseudocysts (PPCs), walled-off necrosis (WON), and acute necrotic collections (ANCs). MethodsThis was a retrospective cohort study of 68 patients with PFCs who underwent EUS-guided drainage. The timing and duration of EUS-guided drainage of various PFCs (ANC, WON, and PPCs) were compared, and the factors influencing the duration of endoscopic treatment were identified. ResultsThe mean time to first EUS-guided PFC drainage since the acute pancreatitis episode was 372.0, 505.0, and 18.7 days for WON, PPC, and ANC, respectively, and the mean duration of treatment was 90, 60, and 63 days, respectively. A disconnected pancreatic duct, a history of percutaneous drainage, and an infected PFC were identified as factors influencing the treatment duration. A positive correlation was observed between the treatment duration and patients’ age. Patients with a disconnected pancreatic duct had to undergo more procedures. In patients with PPC, clinically successful drainage was more frequently achieved after a single procedure without the need for repeated procedures than in those with WON (90% vs. 59%, P = 0.01). ConclusionsPatients with a history of percutaneous drainage, disconnected pancreatic duct, or PFC infection may require longer endoscopic treatment.

Adverse events associated with AXIOS stents: Insights from the manufacturer and user facility device experience database.

ABSTRACTBackground and Objectives:The AXIOS stent is indicated for transgastric or transduodenal drainage of symptomatic pancreatic pseudocysts and symptomatic walled off necrosis. The AXIOS stent functions as a conduit which allows solid and liquid pancreatic fluid collections (PFC) contents to pass into the luminal GI tract and also allows the passage of standard and therapeutic endoscopes into the PFC to perform endoscopic debridement. We aim to investigate the number and type of complications associated with AXIOS stents.Materials and Methods:We analyzed postmarketing surveillance data from the Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database January 2016 to February 2021.Results:During the study period, approximately 588 reports with 579 device issues and 250 patient complications were identified. Most device complications were due to stent positioning problems or stent malpositioning (n = 206; 35.6%), followed by stent migration (n = 72; 12.4%), premature deployment (n = 61; 10.5%), material integrity (n = 56; 9.6%), deployment failure (n = 47; 8.1%), and difficulty removing the stent (n = 45; 7.7%). The most reported patient adverse events were hemorrhage/bleeding (n = 81; 32.4%), perforation (n = 26; 10.4%), pain (n = 22; 8.8%), unspecified infection (n = 20; 8.0%), and death (n = 17; 6.8%).Conclusions:Findings from the MAUDE database highlight patient and device complications which endoscopists should be aware of before AXIOS stent placement.

Safety and efficacy of endoscopic ultrasound as a diagnostic and therapeutic tool in pediatric patients: a multicenter study.

Despite the well-established diagnostic and therapeutic applications of endoscopic ultrasound (EUS) in adults, data about its use in children are limited. In this study, we tried to assess the feasibility, safety, and clinical impact of EUS in pediatric patients. Data of pediatric patients (<18 years) referred for EUS over a 3-year period to the endoscopy units of four Egyptian tertiary centers were retrospectively analyzed. Significant impact was defined as a new diagnosis or treatment attributed to the EUS procedure. Twenty-four diagnostic and five therapeutic EUS procedures were conducted in 29 children with a median age of 9 years. Indications for EUS included assessment of solid pancreatic mass (n = 3), pancreatic cyst (n = 2), suspected chronic pancreatitis (n = 9), pancreatic pseudocyst (PPC) (n = 5), recurrent hypoglycemia (n = 1), bile duct mass (n = 1), subepithelial lesion (esophageal, duodenal or anorectal) (n = 4), mediastinal mass (n = 1), pelvic mass (n = 3), and mass at splenic hilum (n = 1). Therapeutically, five patients underwent cystogastrostomy for symptomatic PPC with 100% technical and clinical success. EUS was able to diagnose 21 out of the other 24 patients. EUS-guided tissue acquisition was performed in 11 patients with definitive histopathological diagnosis in 10 patients (91%). There was no procedure-related major complication, while minor complications occurred in two cases (transient pain in one case, temporary fever, and vomiting in two cases). Standard linear EUS equipment and accessories can be used safely and effectively in selected pediatric patients for diagnostic and therapeutic purposes.

Laparoscopic Intragastric Cystgastrostomy: A Technical Report.

Background: Management of symptomatic pancreatic pseudocysts poses a unique challenge to minimally invasive surgeons. Despite the predominance of endoscopic management of pancreatic pseudocysts, the laparoscopic approach remains a critical skill in the armamentarium of surgeons. Methods: This report details a laparoscopic intragastric approach to create a pancreatic cystgastrostomy using intraoperative ultrasound and endoscopy. Conclusion: Laparoendoscopic techniques for pancreatic pseudocysts are still required in selective cases when endoscopic management is not available or fails. Using this technique provides patients with same clinical benefits of an endoscopic approach.

Minimally invasive approaches for pancreatic pseudocysts: robotic cystgastrostomy

Presenter: Ola Ahmed MD | Washington University, St. Louis Background: The majority of pancreatic pseudocysts resolve without the need for operative intervention. In a select few, surgery may be warranted for large cysts causing symptoms and unamenable to endoscopic or percutaneous drainage procedures Methods: We present the case of 2 patients: a 35 year old lady with a background of EtOH-related pancreatitis and a 43 year old gentleman with a history of gallstone pancreatitis. Both patients developed large symptomatic pancreatic pseudocysts that were unsuited to drain insertion because of the size of the cavity and the presence of a large amount of necrotic debris. Their symptoms of abdominal pain, fullness and early satiety persisted over an 8 – 10 week period and the patients underwent a robotic cystgastrostomy with pancreatic debridement. Results: The post-operative course for both was uneventful and one patient was discharged post-op day 1 while the second patient required a longer stay for social issues and was discharged on day 6. Conclusion: Pancreatic pseudocysts seldom require operative intervention. In a select number of patients, robotic cystgastrostomy is safe and feasible and the robotic approach can be advantageous with enhanced angulation and offering 3 dimensional views for complex retroperitoneal structures

Safety and Feasibility of Robotic-Assisted Drainage of Symptomatic Pancreatic Pseudocysts: A Case-Series Analysis (with video).

Background: The surgical treatment of pancreatic pseudocysts (PPs) in patients who fail nonoperative management has evolved from aggressive open to a minimally invasive approach. The application of robotic surgery in this setting is scarcely reported. The aim of this study is to analyze the safety and feasibility of the robotic approach to pancreatic pseudocyst drainage. Methods: A single centre retrospective review of consecutive patients undergoing robotic-assisted pancreatic pseudocyst surgeries in an academic tertiary institution was performed. Results: There were 14 patients studied, of whom 10 underwent cystogastrostomy and 4 Roux-En- Y cystojejunostomy. Eight patients had gallstone pancreatitis and 3 patients alcoholic pancreatitis. The mean size of cyst was 8.9 +-1cm and 57.1% located at the pancreatic body. The overall operative time of the procedure was 135 +-34 minutes. There were no open conversions. The overall success rate was 92.8%, while the primary success rate 85.7%. The major morbidity rate was 14.3% and there was no 30-day mortality. The mean post-operative hospital stay was 7 +-3 days with one recurrence of the pancreatic pseudocyst on follow-up requiring endoscopic drainage without further recurrence. Conclusions: The robotic approach for the drainage of symptomatic pancreatic pseudocyst is safe and feasible and can be considered as a viable modality for operative intervention in well-selected patients.

Pseudocyst of Pancreas Transplant Allograft: A Case Report

BackgroundPancreatic pseudocysts are rarely reported complications of pancreas transplant. CaseWe present a case of a patient with simultaneous pancreas and kidney transplant with bladder exocrine drainage who developed reflux pancreatitis and symptomatic pancreatic pseudocyst as a result of neuropathic bladder, 15 years after the original transplant. He was initially managed with percutaneous aspiration and drainage along with Foley catheter placement to help with bladder emptying. But the pseudocyst recurred after drains and Foley were removed. Eventually, he underwent an enteric conversion of the pancreas allograft with resolution of his symptoms and the pseudocyst. ConclusionsEnteric conversion should be considered in cases of bladder-drained pancreas transplants with recurrent reflux pancreatitis and/or pseudocyst formation.

Endoscopic retrieval through a lumen-apposing metal stent of a biflanged metal stent that had been released into a peripancreatic fluid collection.

We report a 60-year-old woman with a previous history of an endoscopically treated walled-off necrosis that developed 12 months after an 80-mm recurrent symptomatic pancreatic body pseudocyst. Drainage was attempted using a 16 × 20-mm biflanged metal stent (Nagi), but the stent was mistakenly released inside the collection. A rescue attempt was made to retrieve the stent and avoid surgical intervention.

Endoscopic Ultrasound Guided Pancreatic Pseudocyst drainage experience at a tertiary care unit.

Objective:To evaluate the clinical success, technical success and complications related to Endoscopic ultrasound (EUS) guided Pancreatic pseudocyst (PPC) drainage.Methods:This retrospective study was conducted on the patients with symptomatic PPC who presented over a period of three years, between January 2015 and September 2018, at Endoscopic Suite of Surgical Unit 4, Civil Hospital, Karachi. Record was analyzed for demographic data, indications for the procedure, complications and success related to EUS guided drainage. Statistical analyses were performed using the SPSS Version 22.Results:Total number of patients was 71. Mean age was 37.20 ± 17.27 years with a range of 6 to 68 years. Complications occurred in 12 (8.52%) patients, including stent migration (5/12), bleeding (4/12), infection (1/12), intra-abdominal abscess (1/12) and perforation (1/12). Technical success was achieved in 100% and clinical success in 97.1%. There was no procedure-related mortality.Conclusion:Pancreatic pseudocyst (PPC) is a known complication of acute as well as chronic pancreatitis which can have dreaded and appalling effects. In this part of the world with limited and scarce resources, EUS guided drainage of PPC is most feasible and rational with minimal complications, thus making it a front runner procedure.

2935 Efficacy, Safety and Long-Term Follow-Up of a Single 7 Fr Double Pigtail Plastic Stent for EUS-Guided Pancreatic Pseudocyst Drainage

INTRODUCTION: Endoscopic ultrasound (EUS) guided cystgastrostomy with placement of single or multiple 7 Fr or 10 Fr double-pigtail stent (DPS) is a standard treatment for symptomatic pancreatic pseudocyst (PP). However, using a single 7-Fr DPS is less popular in practice due to the concern of stent patency and adequacy of drainage. Aim: To assess the efficacy, complications and long-term outcomes of a single 7-Fr DPS in the drainage of uncomplicated PP with no detectable internal solid debris or infection. METHODS: Retrospective study of patients undergoing EUS-guided cystgastrostomy with a single 7-Fr DPS during 2010-2018. RESULTS: A total of 14 patients (9 males and 5 females) were identified. The mean age was 48.9 ± 12.5 years. 70% of pseudocysts were located in the pancreatic body; mean size of 10.2 cm (range, 5.5-16.0 cm). Abdominal pain was noted in 11/14 (79%) patients. The most common etiology was biliary pancreatitis (43%). Placement of a 7-Fr × 5 cm DPS had 100% technical success rate without significant complications. At 4 weeks follow-up, clinical success defined as complete resolution or ≥50% decrease in size of pseudocyst in association with resolution of symptoms was 100%. The status of pancreatic duct (PD) was assessed in 10/14 (71%) patients. Of these, 4/10 (40%) had PD leakage; 7/10 (70%) had complete PD disconnection. After a mean follow-up of 52 months (range, 10.1-102.8), pseudocysts resolved without recurrence or the need for additional procedures in 85% of patients. Eleven patients (64%) were noted to have spontaneous stent dislodgement at mean follow-up of 18.3 months (range 0.9-53.2). One patient with PD disruption developed stent migration into the cyst which required two additional sessions of EUS-guided drainage and underwent subsequent cystojejunostomy with stent removal. Another patient had infected cyst due to stent occlusion but she was treated successfully with EUS-guided drainage. Nonetheless, she underwent cystojejonostomy in the end given the presence of complete PD disruption and young age. CONCLUSION: This study demonstrated that treatment of true uncomplicated pseudocysts using a single 7 Fr DPS had an excellent technical and clinical success and respectable long term outcomes. True pseudocysts without internal solid debris are less common. Carefully selected pseudocysts may be effectively and safely treated with a single 7 Fr plastic stent.

Tu1948 USE OF LUMEN APPOSING METAL STENTS IN TREATMENT OF ENTERIC STRICTURES

Lumen apposing metal stents (LAMS) present a sub-type of fully covered self expanding metal stent that have an FDA indication for symptomatic pancreatic pseudocysts. LAMS have also been used off label for a variety of other purposes including small bowel luminal access and transmural gallbladder drainage. In addition, LAMS have been used to treat enteric strictures. In this study we aimed to collect and analyze cases of enteric strictures treated with LAMS.