title: Prospective evaluation of a new biflanged metal stent for the treatment of pancreatic fluid collections (with videos).
abstract: OBJECTIVE
  EUS-guided transluminal drainage (EUS-TD) and sequential direct endoscopic necrosectomy (DEN) for pancreatic fluid collections (PFCs) by using a dedicated biflanged metal stent (BFMS) has been reported as a useful alternative to using plastic stents or a conventional metal stent. However, current dedicated BFMSs have limitations. Recently, a new BFMS with solidly constructed biflanges and various stent lengths matched to the PFC condition has been developed. Herein, we prospectively evaluated this new BFMS for the treatment of PFCs.
  
  
  METHODS
  From July 2015 to July 2016, EUS-TD by using the new BFMS was performed in 12 patients for PFCs (4 patients with pancreatic pseudocysts, 8 patients with walled-off necrosis). When clinical resolution could not be achieved, DEN was performed the following day.
  
  
  RESULTS
  The stent was deployed successfully with a median procedure time of 16 minutes (range 11-24 minutes) and with no procedure-related adverse events in any patients (12/12, 100%). DEN via the stent was achieved in all patients in whom they were attempted (4/4,100%). Spontaneous stent migration or stent dislocation during DEN was not observed in any patients. Two WON patients died from spontaneous pseudoaneurysm rupture and multiple organ failure. The PFCs in the other 10 patients completely resolved, and later the stent was removed with no difficulty in 9 patients after a median time of 48 days (range 30-180 days).
  
  
  CONCLUSIONS
  The new BFMS is technically feasible and safe for the treatment of PFCs. (Clinical trial registration number: UMIN000021347.).
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Mukai
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Tsuchiya
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Shujiro
authors.initials: S
authors.lastname: Tsuji
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Reina
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tonozuka
authors.affiliation: Third Department of Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nagakawa
authors.affiliation: Third Department of Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Kasuya
authors.affiliation: Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Shimatani
authors.affiliation: Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001826:Body Fluids; D004322:Drainage / Q000295:instrumentation*; D016145:Endoscopy, Digestive System; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D009336:Necrosis / Q000601:surgery; D061646:Operative Time; D010179:Pancreas / Q000473:pathology*; D010192:Pancreatic Pseudocyst / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D012086:Reoperation; D015607:Stents
chemical_list: D008670:Metals