Transenteric drainage of pancreatic-fluid collections with fully covered self-expanding metallic stents (with video).
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.
Talreja
Jayant P
JP
Digestive Health Center of Excellence, University of Virginia Health System, Charlottesville, Virginia 22908-0708, USA.
Shami
Vanessa M
VM
Ku
Jennifer
J
Morris
Tanya D
TD
Ellen
Kristi
K
Kahaleh
Michel
M
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