Lumen-Apposing Metal Stents for Walled-Off Pancreatic Necrosis: A Practice Pattern Survey of Gastroenterologists

Autor: V. Raman Muthusamy, Neil B. Marya, Jennifer Phan, Adarsh M. Thaker, Alireza Sedarat, Stephen Kim, M. Phillip Fejleh
Rok vydání: 2021
Předmět:
Zdroj: Techniques and Innovations in Gastrointestinal Endoscopy. 23:145-151
ISSN: 2590-0307
DOI: 10.1016/j.tige.2020.12.007
Popis: Background & Aims Endoscopic ultrasound-guided placement of LAMS has emerged as an effective treatment for WON following acute necrotizing pancreatitis, but a standardized management protocol has not yet emerged. We sought to characterize practice variations in the use of lumen-apposing metal stents (LAMS) for the treatment of walled-off pancreatic necrosis (WON). Methods A 30-question survey was sent to 341 endoscopists in the United States to collect information on practitioner demographics, procedural practices, necrosectomy practices, and LAMS-related adverse events. Results A total of 69 of the 341 surveys were completed for a response rate of 20.2%. Almost all reported using LAMS placement as the primary method of WON treatment (92.5%). At the time of LAMS placement, almost half of respondents perform balloon dilation (45.2%), and a minority place pigtail stents through the LAMS channel (15.0%). Necrosectomy is performed by less than half during index LAMS placement procedure (46.8%). Approximately half never use hydrogen peroxide lavage (52.4%). Most respondents reported experiencing adverse events at some point. About half reported a stent indwell time of the greater than 1 month. Conclusion A convergence of practice patterns when using LAMS to treat WON has not been demonstrated. Considerable variability exists in certain aspects of LAMS use including placement technique, necrosectomy practices, follow-up treatment, and stent removal. Further investigation is necessary to standardize this procedure to effectively and safely treat WON.
Databáze: OpenAIRE
Externí odkaz: