Year 2021 / Volume 113 / Number 3
Letter
Lumen-apposing metal stent deployment failure

224-225

DOI: 10.17235/reed.2020.7060/2020

Pedro López Morales, Miguel Ruiz Marín, Antonio Albarracín Marín-Blázquez,

Abstract
Endoscopic ultrasound-guided transmural drainage has become a first-line therapy for pancreatic fluid collections (1). The appearance of lumen-apposing metal stents has resulted in an authentic revolution, due to their efficacy (clinical success rate of 93%) and easy deployment (technical success rate of 98%) (2). They are associated with a shorter procedure time, lower risk of migration and a wider lumen, which could provide a more effective drainage (3). We report the case of a 78-year-old male who developed an infected pancreatic pseudocyst as a late complication of an acalculous severe acute pancreatitis. An endoscopic ultrasound-guided transmural drainage was performed after a failed computed tomography-guided percutaneous drainage with placement of a pig-tail catheter. A gastrocystic fistula was created and an AxiosTM lumen-apposing metal stent (Boston Scientific; Massachusetts, United States) was inserted. Nevertheless, it remained lodged in the pancreatic pseudocyst at the time of deployment. A computed tomography scan confirmed stent placement inside the collection (Figure 1). After endoscopic balloon dilatation of gastrocystic fistulous tract, removal was unsuccessful with proximal traction of the lumen stent flange using biopsy forceps. Surgical treatment was decided and a gastrotomy was performed, the fistula was identified in the posterior gastric wall and the stent was removed. Endoscopic ultrasound-guided transmural drainage of pancreatic fluid collections using lumen-apposing metal stents is a safe procedure. However, it is not exempt of complications such as stent migration, bleeding, gastrointestinal perforation and air embolism (4). Technical failure of lumen-apposing metal stents deployment is a rare complication that may require surgical treatment if endoscopic removal is not possible.
Share Button
New comment
Comments
No comments for this article
References
1. Han D, Inamdar S, Lee CW et al. Lumen Apposing Metal Stents (LAMSs) for Drainage of Pancreatic and Gallbladder Collections: A Meta-analysis. J Clin Gastroenterol. 2018;52(9):835–44.
2. Hammad T, Khan MA, Alastal Y et al. Efficacy and Safety of Lumen-Apposing Metal Stents in Management of Pancreatic Fluid Collections: Are They Better Than Plastic Stents? A Systematic Review and Meta-Analysis. Dig Dis Sci. 2018;63(2):289–301.
3. Garcia-Garcia de Paredes A, Lopez-Duran S, Foruny J et al. Management of pancreatic collections: An update. Rev Esp Enferm Dig. Pendiente de publicación.
4. Bang JY, Hawes R, Bartolucci A et al. Efficacy of metal and plastic stents for transmural drainage of pancreatic fluid collections: A systematic review. Dig Endosc. 2015;27(4):486–98.
Related articles

Letter

Duodenal lymphangiomas: endoscopic ultrasound features

DOI: 10.17235/reed.2024.10338/2024

Letter

Spontaneous cystogastric fistula: an accidental discovery

DOI: 10.17235/reed.2023.9912/2023

Digestive Diseases Image

Imaging of pancreatic desmoid fibromatosis by endoscopic ultrasound

DOI: 10.17235/reed.2023.9792/2023

Digestive Diseases Image

Endosonographic and ERCP findings in COVID-19 critical illness cholangiopathy

DOI: 10.17235/reed.2022.9218/2022

Letter

Angiosarcoma of the aorta diagnosed via endoscopic ultrasound

DOI: 10.17235/reed.2022.8879/2022

Digestive Diseases Image

Pancreatic lymphoma during pregnancy

DOI: 10.17235/reed.2022.8811/2022

Digestive Diseases Image

When needles are not enough, forceps delivers!

DOI: 10.17235/reed.2022.8697/2022

Letter

Sometimes things are what they seem

DOI: 10.17235/reed.2019.5911/2018

Letter

A giant abdominal collection: when things are not what they seem

DOI: 10.17235/reed.2018.5642/2018

Letter to the Editor

Late migration of a metal stent after EUS-drainage of a pancreatic pseudocyst abscess

DOI: 10.17235/reed.2018.5411/2017

Letter to the Editor

EUS-guided ethanol ablation therapy for gastric stromal tumors

DOI: 10.17235/reed.2017.5361/2017

Letter to the Editor

A rectal neuroendocrine neoplasm

DOI: 10.17235/reed.2017.4836/2017

Review

Endoscopic ampullectomy: a technical review

DOI: 10.17235/reed.2016.3867/2015

Case Report

Pseudoaneurysm associated with complicated pancreatic pseudocysts

DOI: 10.17235/reed.2016.3855/2015

Case Report

Pelvic inflammatory myofibroblastic tumor mimicking a rectal cancer

DOI: 10.17235/reed.2015.3777/2015

Citation tools
López Morales P, Ruiz Marín M, Albarracín Marín-Blázquez A. Lumen-apposing metal stent deployment failure. 7060/2020


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1253 visits.
This article has been downloaded 154 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 21/03/2020

Accepted: 01/04/2020

Online First: 19/11/2020

Published: 08/03/2021

Article Online First time: 243 days

Article editing time: 352 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2024 y Creative Commons. The Spanish Journal of Gastroenterology