Use of a novel lumen apposing metallic stent for drainage of the bile duct and gallbladder: Long term outcomes of a prospective international trial

Autor:	Rungsun Reknimitr, Thawee Ratanachu, Shannon M. Chan, Jahangeer B. Medarapalem, Anthony Yuen Bun Teoh, Wiriyaporn Ridtitid, Sundeep Lakthakia, Jong Ho Moon, Amol Bapaye, Sravan K. Korrapati, Harshal P. Gadhikar, Pradermchai Kongkam, Yun Nah Lee
Rok vydání:	2021
Předmět:	medicine.medical_specialty medicine.medical_treatment Lumen (anatomy) Endosonography 03 medical and health sciences 0302 clinical medicine medicine Acute cholecystitis Humans Radiology Nuclear Medicine and imaging Prospective Studies Adverse effect Bile duct business.industry Mortality rate Gallbladder Gastroenterology Stent digestive system diseases Surgery Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Drainage Stents 030211 gastroenterology & hepatology Cholecystectomy Bile Ducts business
Zdroj:	Digestive Endoscopy. 33:1139-1145
ISSN:	1443-1661 0915-5635
DOI:	10.1111/den.13911
Popis:	BACKGROUND Long-term placement of lumen apposing metal stents (LAMS) with high lumen apposing force may result in adverse events. The aim of the current study was to assess the long-term efficacy and safety of a self-approximating LAMS with lower lumen apposing force for endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) and -gallbladder drainage (EUS-GBD). METHODS Five Asian institutions participated in this study. Consecutive patients suffering from obstructive jaundice with failed ERCP or acute cholecystitis that were at high risk for cholecystectomy were recruited. We evaluated the technical and clinical success rates, adverse events rates, types of interventions through the stent and the patency profile. RESULTS From June 2017 to Oct 2018, a total of 53 patients received EUS-CDS (26) and EUS-GBD (27). The technical and clinical success rates were similar between the two groups (88.5% vs 88.9%, P = 1 and 88.5% vs 88.9%, P = 1 respectively). The differences in 30-day mortality rates [2 (7.7%) vs 2 (7.7%), P = 1] and adverse events [3 (11.5%) vs 3 (11.5%), P = 1] did not reach significance. Regarding long-term outcomes, two patients in each group suffered from adverse events (P = 1). One patient in the EUS-GBD group who was on direct oral anticoagulant suffered from stent induced bleeding. CONCLUSION The self-approximating LAMS with lower lumen apposing force was effective and safe with a low risk of buried stent syndrome and bleeding in the longer term. The ClinicalTrials.gov Identifier was NCT03002051.
Databáze:	OpenAIRE
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