title: Endoscopic drainage of walled-off pancreatic necrosis using a novel self-expanding metal stent.
abstract: OBJECTIVE
  This report describes the use of a novel, fully covered, self-expanding metal stent (FCSEMS) for endoscopic ultrasound (EUS)-guided drainage of walled-off pancreatic necrosis (WON).
  
  
  METHODS
  Patients with WON, as defined by the revised Atlanta Criteria, were included in this open-lable, two-center, observational study. The WON was punctured using a cystotome, and the FCSEMS was inserted under fluoroscopic guidance. Necrosectomy procedures were performed as necessary.
  
  
  RESULTS
  A total of 19 patients were included. The median maximum collection size was 15 cm with a median of 50 % necrosis. A total of 14/19 patients underwent necrosectomy, requiring a median of 4 procedures. Resolution or reduction in the size of collection by at least 80 % was achieved in all patients. Percutaneous or surgical drainage was required in three patients. Five stents migrated or dislodged. One patient had abdominal pain post-procedure. Five patients died during follow-up (three from multi-organ failure, and two unrelated to pancreatitis).
  
  
  CONCLUSIONS
  Use of this stent is feasible and safe for drainage of WON. However, stent displacement rates were high, and improvements to the stent design are required before it can be advocated for routine use in WON.
authors.affiliation: Department of Gastroenterology, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.
authors.forename: Matthew T
authors.initials: MT
authors.lastname: Huggett
authors.affiliation: Department of Gastroenterology, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.
authors.forename: Kofi W
authors.initials: KW
authors.lastname: Oppong
authors.affiliation: Department of Gastroenterology, University College Hospital, London, United Kingdom.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Pereira
authors.affiliation: Department of Gastroenterology, University College Hospital, London, United Kingdom.
authors.forename: Margaret G
authors.initials: MG
authors.lastname: Keane
authors.affiliation: Department of Gastroenterology, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.
authors.forename: Vikramjit
authors.initials: V
authors.lastname: Mitra
authors.affiliation: Department of HPB Surgery, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Charnley
authors.affiliation: Department of Gastroenterology, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.
authors.forename: Manu K
authors.initials: MK
authors.lastname: Nayar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004322:Drainage / Q000379:methods*; D016145:Endoscopy, Digestive System / Q000379:methods*; D019160:Endosonography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D019283:Pancreatitis, Acute Necrotizing / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult