EUS-guided stent removal in buried lumen-apposing metal stent syndrome: a case series.
LAMS, lumen-apposing metal stent
PFC, pancreatic fluid collection
WON, walled-off necrosis
Journal
VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy
ISSN: 2468-4481
Titre abrégé: VideoGIE
Pays: United States
ID NLM: 101719677
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
entrez:
11
1
2020
pubmed:
11
1
2020
medline:
11
1
2020
Statut:
epublish
Résumé
Lumen-apposing metal stents (LAMSs) play an increasing role in transgastric and transduodenal drainage of pancreatic fluid collections and allow novel EUS-guided interventions. Alongside the main adverse events of bleeding and occlusion, LAMSs can be overgrown by mucosa, which leads to the inability to visualize the stent in endoscopy. We describe a series of 4 cases of buried LAMSs that were removed under EUS guidance for identification of the stent followed by removal with rat-tooth forceps. The median in situ time of the LAMSs in the reported 4 cases was 53 days. All stents could no longer be visualized endoscopically when drainage of necrosis was complete. All 4 buried LAMSs could be identified by EUS and were removed successfully with forceps. In 1 case, balloon dilation of the stent tract was performed before stent removal. No adverse events were observed after the procedure. Buried stent syndrome is a rare adverse event of LAMSs. Here we describe a safe and effective approach for stent identification and removal without prior mucosal dissection.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Lumen-apposing metal stents (LAMSs) play an increasing role in transgastric and transduodenal drainage of pancreatic fluid collections and allow novel EUS-guided interventions. Alongside the main adverse events of bleeding and occlusion, LAMSs can be overgrown by mucosa, which leads to the inability to visualize the stent in endoscopy.
METHODS
METHODS
We describe a series of 4 cases of buried LAMSs that were removed under EUS guidance for identification of the stent followed by removal with rat-tooth forceps.
RESULTS
RESULTS
The median in situ time of the LAMSs in the reported 4 cases was 53 days. All stents could no longer be visualized endoscopically when drainage of necrosis was complete. All 4 buried LAMSs could be identified by EUS and were removed successfully with forceps. In 1 case, balloon dilation of the stent tract was performed before stent removal. No adverse events were observed after the procedure.
CONCLUSIONS
CONCLUSIONS
Buried stent syndrome is a rare adverse event of LAMSs. Here we describe a safe and effective approach for stent identification and removal without prior mucosal dissection.
Identifiants
pubmed: 31922082
doi: 10.1016/j.vgie.2019.09.002
pii: S2468-4481(19)30248-6
pmc: PMC6945230
doi:
Types de publication
Journal Article
Langues
eng
Pagination
37-40Informations de copyright
© 2019 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc.
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