title: Endoscopic ultrasound-guided transmural drainage of infected pancreatic fluid collections with placement of covered self-expanding metal stents: a case series.
abstract: Endoscopic ultrasound-guided transmural drainage (EUS-GTD) has become the standard procedure for treating symptomatic pancreatic fluid collections. The aim of this series was to evaluate the efficacy and safety of covered self-expanding metal stent (CSEMS) placement for treating infected pancreatic fluid collections. From January 2007 to May 2010, 22 patients (18 M/4F; mean age 56.9) with infected pancreatic fluid collections (mean size, 13.2 cm) at two Italian centers were evaluated for EUS-GTD. In 20 of the 22 patients, EUS-GTD with CSEMS placement was indicated. Early complications occurred in two patients: one patient developed a superinfection, which was managed conservatively, and one experienced stent migration and superinfection, and was managed surgically. The CSEMSs were removed without difficulty in 18 patients after a median of 26 days, while stent removal failed in one patient due to inflammatory tissue ingrowth; instead it was removed during surgery performed for renal cancer. Clinical success was achieved without additional intervention in 17 patients during a mean follow-up of 610 days; only one symptomatic recurrence was observed. In our experience, EUS-GTD with CSEMS placement appears safe for the treatment of infected pancreatic fluid collections.
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy. carlo.fabbri@ausl.bologna.it
authors.forename: C
authors.initials: C
authors.lastname: Fabbri
authors.forename: C
authors.initials: C
authors.lastname: Luigiano
authors.forename: V
authors.initials: V
authors.lastname: Cennamo
authors.forename: A M
authors.initials: AM
authors.lastname: Polifemo
authors.forename: L
authors.initials: L
authors.lastname: Barresi
authors.forename: E
authors.initials: E
authors.lastname: Jovine
authors.forename: M
authors.initials: M
authors.lastname: Traina
authors.forename: N
authors.initials: N
authors.lastname: D'Imperio
authors.forename: I
authors.initials: I
authors.lastname: Tarantino
mesh_terms: D019072:Antibiotic Prophylaxis; D020878:Device Removal; D004322:Drainage / Q000295:instrumentation* / Q000379:methods*; D019160:Endosonography / Q000379:methods; D004869:Equipment Safety; D005122:Exudates and Transudates / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000628:therapy*; D010195:Pancreatitis / Q000150:complications*; D015607:Stents / Q000009:adverse effects; D015163:Superinfection / Q000209:etiology; D013813:Therapy, Computer-Assisted; D018608:Ultrasonography, Doppler