Lumen-apposing metal stent placement for drainage of pancreatic fluid collections: predictors of adverse events

Although rare in occurrence, adverse events such as delayed bleeding and buried stent syndrome have been reported after lumen-apposing metal stents (LAMS) placement in patients undergoing endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs). In a prospective study, we observed delayed adverse events in 6.4% of 188 patients which occurred when the PFCs were 7 cm or smaller in size and the removal of LAMS was delayed beyond 4 weeks. LAMS are being increasingly preferred over double pigtail plastic stents for patients undergoing EUS-guided PFC drainage because their deployment is technically easy and the wide lumen facilitates quick drainage of cyst contents. However, delayed adverse events such as bleeding and buried stent syndrome have been reported after LAMS placement.1–3 In this study, we attempted to identify predictors of adverse events by examining data that were collected prospectively in all patients undergoing EUS-guided PFC drainage using LAMS. By institutional protocol, after LAMS placement, the endoprostheses were removed at outpatient follow-up in 3–4 weeks and all patients were contacted by telephone call to obtain follow-up at 6 months. The data collected included 292 demographic, laboratory, radiological, technical, clinical and treatment outcome variables, with a minimum follow-up duration of 6 months (NCT02422095). Patient details, PFC characteristics, disease severity and clinical outcomes were summarised as means with SD and medians with IQR for continuous variables and as frequencies and proportions for categorical variables. In order to identify the factors associated with …