scholarly journals Challenging Lumen-Apposing Metal Stent Removal after Successful Drainage of a Pancreatic Pseudocyst

2018 ◽  
Vol 25 (6) ◽  
pp. 333-334
Author(s):  
Athanasios D. Sioulas ◽  
Konstantina Papadaki ◽  
Dimitrios Schizas ◽  
Ilias Scotiniotis
Keyword(s):  
Pancreatic Pseudocyst ◽  
Metal Stent ◽  
Stent Removal

scholarly journals Pancreatic pseudocyst-portal vein fistula with refractory hepatic pseudocyst: Two cases treated with EUS cyst-gastrostomy and review of the literature

2019 ◽  
Vol 07 (01) ◽  
pp. E83-E86 ◽  
Author(s):  
John Eccles ◽  
Edward Wiebe ◽  
Pernilla D’Souza ◽  
Gurpal Sandha
Keyword(s):  
Portal Vein ◽  
Pancreatic Pseudocyst ◽  
Pancreatic Cyst ◽  
Treatment Approach ◽  
Fistula Formation ◽  
Pancreatic Pseudocysts ◽  
Stent Insertion ◽  
Metal Stent ◽  
Pancreatic Fluid ◽  
Pseudocyst Formation

Abstract Background and study aims Pseudocysts are the most common pancreatic cystic lesions and they usually develop in association with pancreatitis of at least 4 weeks’ duration. Extra-pancreatic pseudocysts, although reported, are relatively uncommon. Secondary liver pseudocysts are recognized within the literature, and most patients described have required percutaneous or surgical drainage due to infection or symptoms. The mechanism of hepatic pseudocyst formation is not entirely clear but it is postulated that this phenomenon may occur through pseudocyst-portal vein fistulization. We describe two cases of patients presenting with pancreatic pseudocysts invading the portal venous system with embolization of pancreatic fluid to the liver and subsequent hepatic pseudocyst formation. Interestingly, liver pseudocyst resolution was incomplete with antibiotics and percutaneous drainage alone, and only occurred following endoscopic ultrasonography-guided pancreatic cyst-gastrostomy and metal stent insertion. We have reviewed the current literature on the diagnosis and management of pseudocyst-portal vein fistula formation and we believe that our cases represent the first published within the literature to describe this treatment approach.

P.04.21 PSEUDOCYSTS' METAL STENT DRAINAGE: STENT REMOVAL IS NOT MANDATORY

2018 ◽  
Vol 50 (2) ◽  
pp. e164
Author(s):  
E. Forti ◽  
L. Dioscoridi ◽  
F. Pugliese ◽  
A. Tringali ◽  
M. Cintolo ◽  
...  
Keyword(s):  
Metal Stent ◽  
Stent Removal

scholarly journals Side-by-side partially covered self-expandable metal stent placement for malignant hilar biliary obstruction

2017 ◽  
Vol 05 (12) ◽  
pp. E1211-E1217 ◽  
Author(s):  
Katsuya Kitamura ◽  
Akira Yamamiya ◽  
Yu Ishii ◽  
Yuta Mitsui ◽  
Tomohiro Nomoto ◽  
...  
Keyword(s):  
Stent Placement ◽  
Biliary Obstruction ◽  
Success Rates ◽  
Metal Stent ◽  
Stent Removal ◽  
Tumor Ingrowth ◽  
Hilar Biliary Obstruction ◽  
Malignant Hilar Biliary Obstruction ◽  
Self Expandable Metal Stent

Abstract Background and study aims This study investigated the feasibility of side-by-side (SBS) partially covered self-expandable metal stent (PCSEMS) placement for unresectable malignant hilar biliary obstruction (MHBO). Patients and methods We retrospectively analyzed 33 patients from a single center who underwent endoscopic biliary drainage for unresectable MHBO from July 2013 to June 2015. In all patients with bilateral obstruction during complete bilateral intrahepatic cholangiograms, we performed endoscopic SBS placement of a 6-mm diameter PCSEMS using an 8-French delivery system. All patients underwent endoscopic sphincterotomy. Generally, patients with recurrent biliary obstruction (RBO) after stent placement underwent endoscopic reintervention. Our study outcomes included the technical and functional success rates, RBO rate, time to RBO (TRBO), reintervention rate, and incidence of adverse events. Results Seventeen patients with unresectable MHBO during complete bilateral intrahepatic cholangiograms underwent endoscopic SBS PCSEMS placement (median age, 78 years; men, 9). Lesions were Bismuth types II (n = 10), III (n = 1), and IV (n = 6), including 10 cholangiocarcinomas, 3 gallbladder cancers, and 4 metastatic cancers. In all patients, the PCSEMS was placed across the duodenal papilla. The technical and functional success rates were 100 % and 82 %, respectively. The median procedure time was 43 minutes (interquartile range [IQR]: 36 – 52 minutes). Twelve patients had RBO (71 %), including 9 stent occlusions due to sludge and 3 stent migrations. The median TRBO was 79 days (IQR: 58 – 156 days) during the follow-up period (median 192 days [IQR: 88 – 551 days]). The median TRBO of patients with Bismuth type II lesions was significantly longer than that of patients with Bismuth types III and IV lesions (87 days [IQR: 70 – 244 days] vs. 54 days [IQR: 35 – 100 days]; P  = 0.030). Thirteen patients (76 %) required endoscopic reintervention. Endoscopic stent removal was possible in 6 patients without tumor ingrowth into the uncovered distal part of the stent. One late adverse event (≥ 31 days) occurred (cholangitis). Conclusions Endoscopic SBS placement of a PCSEMS was feasible in patients with unresectable MHBO. Additionally, reinterventional stent removal was possible in the absence of tumor ingrowth.

Single Operator Cholangioscopy After Metal Stent Removal: What Have We Learned?

2009 ◽  
Vol 69 (5) ◽  
pp. AB142
Author(s):  
Bryan Sauer ◽  
Andrew Y. Wang ◽  
Michele E. Rehan ◽  
Animesh Jain ◽  
Kristi Ellen ◽  
...  
Keyword(s):  
Metal Stent ◽  
Stent Removal ◽  
Single Operator

scholarly journals Endoscopic ultrasound-guided transesophageal drainage of a mediastinal pancreatic pseudocyst using a novel lumen-apposing metal stent

Endoscopy ◽  
2012 ◽  
Vol 44 (S 02) ◽  
pp. E211-E212 ◽  
Author(s):  
J. Gornals ◽  
C. Loras ◽  
R. Mast ◽  
J. Botargues ◽  
J. Busquets ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Pancreatic Pseudocyst ◽  
Metal Stent ◽  
Ultrasound Guided

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

2018 ◽  
Vol 110 ◽  
Author(s):  
Belén Maldonado Pérez ◽  
María Fernanda Guerra Veloz ◽  
Rafael Romero Castro
Keyword(s):  
Pancreatic Pseudocyst ◽  
Metal Stent

Protocol of early lumen apposing metal stent removal for pseudocysts and walled off necrosis avoids bleeding complications

2020 ◽  
Vol 55 (2) ◽  
pp. 242-247 ◽  
Author(s):  
Waseem Ahmad ◽  
Syed A. Fehmi ◽  
Thomas J. Savides ◽  
Gobind Anand ◽  
Michael A. Chang ◽  
...  
Keyword(s):  
Bleeding Complications ◽  
Metal Stent ◽  
Stent Removal ◽  
Walled Off Necrosis
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