title: Pancreatic-fluid collections: a randomized controlled trial regarding stent removal after endoscopic transmural drainage.
abstract: BACKGROUND
  Endoscopic transmural drainage is obtained by creating a communication between the intestinal tract and the pancreatic-fluid collection, and then inserting 1 or more stents. Collection recurrence after therapy is noted in 10% to 30% of cases. It is not known whether leaving the stents in position reduces recurrence rates.
  
  
  OBJECTIVE
  To test the hypothesis that patients who have undergone previous successful pancreatic-collection drainage and whose stents are retrieved have higher recurrence rates.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  During a period of 27 months, 46 of 77 patients who had undergone endoscopic transmural drainage for pancreatic collections met inclusion or exclusion criteria, and 28 of these patients were randomized.
  
  
  METHODS
  Fifteen patients were assigned to group A, whose stents were left in place, and 13 were assigned to group B, whose stents were removed after collection resolution. The remaining 18 patients, who were not randomized, also had their stents left in place. All 46 patients were similarly followed.
  
  
  METHODS
  Recurrence of the same pancreatic collection that required therapy.
  
  
  RESULTS
  All patients were followed for a median period of 14 months (interquartile range, 8.2-22 months) after treatment. The primary end point was reached in 5 patients in group B (stent retrieval), as opposed to none in group A (P = .013). Moreover, no recurrence was observed in the remaining 18 nonrandomized patients.
  
  
  CONCLUSIONS
  Small sample size.
  
  
  CONCLUSIONS
  In patients who underwent successful transmural drainage of pancreatic collections, stent retrieval was associated with higher recurrence rates.
authors.affiliation: Department of Gastroenterology, Erasme University Hospital, Brussels, Belgium.
authors.forename: Marianna
authors.initials: M
authors.lastname: Arvanitakis
authors.forename: Myriam
authors.initials: M
authors.lastname: Delhaye
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Bali
authors.forename: Celso
authors.initials: C
authors.lastname: Matos
authors.forename: Viviane
authors.initials: V
authors.lastname: De Maertelaer
authors.forename: Olivier
authors.initials: O
authors.lastname: Le Moine
authors.forename: Jacques
authors.initials: J
authors.lastname: Devière
mesh_terms: D000328:Adult; D020878:Device Removal / Q000706:statistics & numerical data*; D004322:Drainage; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000517:prevention & control / Q000601:surgery*; D010189:Pancreatic Juice; D011446:Prospective Studies; D055502:Secondary Prevention; D015607:Stents; D016896:Treatment Outcome