title: Transenteric drainage of pancreatic-fluid collections with fully covered self-expanding metallic stents (with video).
abstract: BACKGROUND
  Drainage of pancreatic-fluid collections (PFCs) by using fully covered self-expanding metallic stents (CSEMSs) offers the option of providing a larger-diameter access fistula for drainage when compared with plastic stents.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of transenteric drainage of PFCs by using CSEMSs.
  
  
  METHODS
  A prospective case series.
  
  
  METHODS
  A tertiary-referral center.
  
  
  METHODS
  Between January 2007 and September 2007, 18 patients underwent drainage of PFCs by using CSEMSs. Follow-up and final results were prospectively recorded until May 2008.
  
  
  METHODS
  Placement of CSEMSs with a double-pigtail stent placed alongside (4 cases) or into the CSEMS (14 cases) to prevent migration.
  
  
  METHODS
  The number of sessions and time to resolution of the PFCs.
  
  
  RESULTS
  A median of 1 session was required to achieve drainage (range 1-4) when using CSEMSs. Complications included superinfection (5), bleeding (2), and inner migration (1). A total of 17 of 18 patients (95%) responded successfully, with 14 patients (78%) achieving complete resolution of their PFC. The mean (+/- SD) time of follow-up until final resolution was 77 +/- 80 days (range 15-310 days).
  
  
  CONCLUSIONS
  Placement of CSEMSs seems to offer an effective and safe alternative for the drainage of PFCs. A randomized controlled trial should be performed to compare this technique with plastic-stent drainage.
authors.affiliation: Digestive Health Center of Excellence, University of Virginia Health System, Charlottesville, Virginia 22908-0708, USA.
authors.forename: Jayant P
authors.initials: JP
authors.lastname: Talreja
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: Shami
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ku
authors.forename: Tanya D
authors.initials: TD
authors.lastname: Morris
authors.forename: Kristi
authors.initials: K
authors.lastname: Ellen
authors.forename: Michel
authors.initials: M
authors.lastname: Kahaleh
mesh_terms: D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000601:surgery*; D011446:Prospective Studies; D011474:Prosthesis Design; D015607:Stents; D014741:Video Recording