Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using 20-mm versus 15-mm lumen-apposing metal stents: An international, multicenter, case-matched study

Nasim Parsa; Jose M. Nieto; Patrick Powers; Shuji Mitsuhashi; Abdelhai Abdelqader; George Hadzinakos; Andrea A. Anderloni; Alessandro Fugazza; Theodore W. James; Alexander Arlt; Mark Ellrichmann; Jose Ramon Aparicio; Arvind J. Trindade; Tyler K. Stevens; Prabhleen Chahal; Shawn L. Shah; Ahmed A. Messallam; Gabriel Lang; M. Phillip Fejleh; Petros C. Benias; Divyesh V. Sejpal; Jason Jones; Fahad Faisal Mir; Mohamad Aghaie Meybodi; Yervant Ichkhanian; Kia Vosoughi; Aleksey A. Novikov; Shayan S. Irani; Rishi Pawa; Ali M. Ahmed; Alireza Sedarat; William Hsueh; Jochen Hampe; Reem Z. Sharaiha; Tyler M. Berzin; Field F. Willingham; Vladimir M. Kushnir; Olaya I. Brewer Gutierrez; Saowanee Ngamruengphong; Matthew T. Huggett; Todd H. Baron; Alessandro Repici; Douglas G. Adler; John T. Nasr; Thomas E. Kowalski; Vivek Kumbhari; Vikesh K. Singh; Mouen A. Khashab

doi:10.1055/a-1096-3299

Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using 20-mm versus 15-mm lumen-apposing metal stents: An international, multicenter, case-matched study

Nasim Parsa, Jose M. Nieto, Patrick Powers, Shuji Mitsuhashi, Abdelhai Abdelqader, George Hadzinakos, Andrea A. Anderloni, Alessandro Fugazza, Theodore W. James, Alexander Arlt, Mark Ellrichmann, Jose Ramon Aparicio, Arvind J. Trindade, Tyler K. Stevens, Prabhleen Chahal, Shawn L. Shah, Ahmed A. Messallam, Gabriel Lang, M. Phillip Fejleh, Petros C. BeniasDivyesh V. Sejpal, Jason Jones, Fahad Faisal Mir, Mohamad Aghaie Meybodi, Yervant Ichkhanian, Kia Vosoughi, Aleksey A. Novikov, Shayan S. Irani, Rishi Pawa, Ali M. Ahmed, Alireza Sedarat, William Hsueh, Jochen Hampe, Reem Z. Sharaiha, Tyler M. Berzin, Field F. Willingham, Vladimir M. Kushnir, Olaya I. Brewer Gutierrez, Saowanee Ngamruengphong, Matthew T. Huggett, Todd H. Baron, Alessandro Repici, Douglas G. Adler, John T. Nasr, Thomas E. Kowalski, Vivek Kumbhari, Vikesh K. Singh, Mouen A. Khashab

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Abstract

Backgrounds â Endoscopic ultrasound (EUS)-guided placement of lumen-apposing metal stents (LAMSs) has gained popularity for the treatment of pancreatic walled-off necrosis (WON). We compared the 20-mm and 15-mm LAMSs for the treatment of symptomatic WON in terms of clinical success and adverse events. Methods â We conducted a retrospective, case-matched study of 306 adults at 22 tertiary centers from 04/2014 to 10/2018. A total of 102 patients with symptomatic WON who underwent drainage with 20-mm LAMS (cases) and 204 patients who underwent drainage with 15-mm LAMS (controls) were matched by age, sex, and drainage approach. Conditional logistic regression analysis was performed to compare clinical success (resolution of WON on follow-up imaging without reintervention) and adverse events (according to American Society for Gastrointestinal Endoscopy criteria). Results â Clinical success was achieved in 92.2âŠ% of patients with 20-mm LAMS and 91.7âŠ% of patients with 15-mm LAMS (odds ratio 0.92; P âŠ=âŠ0.91). Patients with 20-mm LAMS underwent fewer direct endoscopic necrosectomy (DEN) sessions (mean 1.3 vs. 2.1; P âŠ<âŠ0.001), despite having larger WON collections (transverse axis 118.2 vs. 101.9âŠmm, P âŠ=âŠ0.003; anteroposterior axis 95.9 vs. 80.1âŠmm, P âŠ=âŠ0.01). There was no difference in overall adverse events (21.6âŠ% vs. 15.2âŠ%; P âŠ=âŠ0.72) and bleeding events (4.9âŠ% vs. 3.4âŠ%; P âŠ=âŠ0.54) between the 20-mm and 15-mm LAMS groups, respectively. Conclusions â The 20-mm LAMS showed comparable clinical success and safety profile to the 15-mm LAMS, with the need for fewer DEN sessions for WON resolution.

Original language	English
Pages (from-to)	211-219
Number of pages	9
Journal	Endoscopy
Volume	52
Issue number	3
DOIs	https://doi.org/10.1055/a-1096-3299
State	Published - Mar 1 2020

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Parsa, N., Nieto, J. M., Powers, P., Mitsuhashi, S., Abdelqader, A., Hadzinakos, G., Anderloni, A. A., Fugazza, A., James, T. W., Arlt, A., Ellrichmann, M., Aparicio, J. R., Trindade, A. J., Stevens, T. K., Chahal, P., Shah, S. L., Messallam, A. A., Lang, G., Fejleh, M. P., ... Khashab, M. A. (2020). Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using 20-mm versus 15-mm lumen-apposing metal stents: An international, multicenter, case-matched study. Endoscopy, 52(3), 211-219. https://doi.org/10.1055/a-1096-3299

@article{809c6a07d568465f81b38f55f574ea19,

title = "Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using 20-mm versus 15-mm lumen-apposing metal stents: An international, multicenter, case-matched study",

abstract = "Backgrounds {\^a} Endoscopic ultrasound (EUS)-guided placement of lumen-apposing metal stents (LAMSs) has gained popularity for the treatment of pancreatic walled-off necrosis (WON). We compared the 20-mm and 15-mm LAMSs for the treatment of symptomatic WON in terms of clinical success and adverse events. Methods {\^a} We conducted a retrospective, case-matched study of 306 adults at 22 tertiary centers from 04/2014 to 10/2018. A total of 102 patients with symptomatic WON who underwent drainage with 20-mm LAMS (cases) and 204 patients who underwent drainage with 15-mm LAMS (controls) were matched by age, sex, and drainage approach. Conditional logistic regression analysis was performed to compare clinical success (resolution of WON on follow-up imaging without reintervention) and adverse events (according to American Society for Gastrointestinal Endoscopy criteria). Results {\^a} Clinical success was achieved in 92.2{\^a}{\v S}% of patients with 20-mm LAMS and 91.7{\^a}{\v S}% of patients with 15-mm LAMS (odds ratio 0.92; P {\^a}{\v S}={\^a}{\v S}0.91). Patients with 20-mm LAMS underwent fewer direct endoscopic necrosectomy (DEN) sessions (mean 1.3 vs. 2.1; P {\^a}{\v S}<{\^a}{\v S}0.001), despite having larger WON collections (transverse axis 118.2 vs. 101.9{\^a}{\v S}mm, P {\^a}{\v S}={\^a}{\v S}0.003; anteroposterior axis 95.9 vs. 80.1{\^a}{\v S}mm, P {\^a}{\v S}={\^a}{\v S}0.01). There was no difference in overall adverse events (21.6{\^a}{\v S}% vs. 15.2{\^a}{\v S}%; P {\^a}{\v S}={\^a}{\v S}0.72) and bleeding events (4.9{\^a}{\v S}% vs. 3.4{\^a}{\v S}%; P {\^a}{\v S}={\^a}{\v S}0.54) between the 20-mm and 15-mm LAMS groups, respectively. Conclusions {\^a} The 20-mm LAMS showed comparable clinical success and safety profile to the 15-mm LAMS, with the need for fewer DEN sessions for WON resolution.",

author = "Nasim Parsa and Nieto, {Jose M.} and Patrick Powers and Shuji Mitsuhashi and Abdelhai Abdelqader and George Hadzinakos and Anderloni, {Andrea A.} and Alessandro Fugazza and James, {Theodore W.} and Alexander Arlt and Mark Ellrichmann and Aparicio, {Jose Ramon} and Trindade, {Arvind J.} and Stevens, {Tyler K.} and Prabhleen Chahal and Shah, {Shawn L.} and Messallam, {Ahmed A.} and Gabriel Lang and Fejleh, {M. Phillip} and Benias, {Petros C.} and Sejpal, {Divyesh V.} and Jason Jones and Mir, {Fahad Faisal} and {Aghaie Meybodi}, Mohamad and Yervant Ichkhanian and Kia Vosoughi and Novikov, {Aleksey A.} and Irani, {Shayan S.} and Rishi Pawa and Ahmed, {Ali M.} and Alireza Sedarat and William Hsueh and Jochen Hampe and Sharaiha, {Reem Z.} and Berzin, {Tyler M.} and Willingham, {Field F.} and Kushnir, {Vladimir M.} and {Brewer Gutierrez}, {Olaya I.} and Saowanee Ngamruengphong and Huggett, {Matthew T.} and Baron, {Todd H.} and Alessandro Repici and Adler, {Douglas G.} and Nasr, {John T.} and Kowalski, {Thomas E.} and Vivek Kumbhari and Singh, {Vikesh K.} and Khashab, {Mouen A.}",

year = "2020",

month = mar,

day = "1",

doi = "10.1055/a-1096-3299",

language = "English",

volume = "52",

pages = "211--219",

journal = "Endoscopy",

issn = "0013-726X",

number = "3",

}

Parsa, N, Nieto, JM, Powers, P, Mitsuhashi, S, Abdelqader, A, Hadzinakos, G, Anderloni, AA, Fugazza, A, James, TW, Arlt, A, Ellrichmann, M, Aparicio, JR, Trindade, AJ, Stevens, TK, Chahal, P, Shah, SL, Messallam, AA, Lang, G, Fejleh, MP, Benias, PC, Sejpal, DV, Jones, J, Mir, FF, Aghaie Meybodi, M, Ichkhanian, Y, Vosoughi, K, Novikov, AA, Irani, SS, Pawa, R, Ahmed, AM, Sedarat, A, Hsueh, W, Hampe, J, Sharaiha, RZ, Berzin, TM, Willingham, FF, Kushnir, VM, Brewer Gutierrez, OI, Ngamruengphong, S, Huggett, MT, Baron, TH, Repici, A, Adler, DG, Nasr, JT, Kowalski, TE, Kumbhari, V, Singh, VK & Khashab, MA 2020, 'Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using 20-mm versus 15-mm lumen-apposing metal stents: An international, multicenter, case-matched study', Endoscopy, vol. 52, no. 3, pp. 211-219. https://doi.org/10.1055/a-1096-3299

TY - JOUR

T1 - Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using 20-mm versus 15-mm lumen-apposing metal stents

T2 - An international, multicenter, case-matched study

AU - Parsa, Nasim

AU - Nieto, Jose M.

AU - Powers, Patrick

AU - Mitsuhashi, Shuji

AU - Abdelqader, Abdelhai

AU - Hadzinakos, George

AU - Anderloni, Andrea A.

AU - Fugazza, Alessandro

AU - James, Theodore W.

AU - Arlt, Alexander

AU - Ellrichmann, Mark

AU - Aparicio, Jose Ramon

AU - Trindade, Arvind J.

AU - Stevens, Tyler K.

AU - Chahal, Prabhleen

AU - Shah, Shawn L.

AU - Messallam, Ahmed A.

AU - Lang, Gabriel

AU - Fejleh, M. Phillip

AU - Benias, Petros C.

AU - Sejpal, Divyesh V.

AU - Jones, Jason

AU - Mir, Fahad Faisal

AU - Aghaie Meybodi, Mohamad

AU - Ichkhanian, Yervant

AU - Vosoughi, Kia

AU - Novikov, Aleksey A.

AU - Irani, Shayan S.

AU - Pawa, Rishi

AU - Ahmed, Ali M.

AU - Sedarat, Alireza

AU - Hsueh, William

AU - Hampe, Jochen

AU - Sharaiha, Reem Z.

AU - Berzin, Tyler M.

AU - Willingham, Field F.

AU - Kushnir, Vladimir M.

AU - Brewer Gutierrez, Olaya I.

AU - Ngamruengphong, Saowanee

AU - Huggett, Matthew T.

AU - Baron, Todd H.

AU - Repici, Alessandro

AU - Adler, Douglas G.

AU - Nasr, John T.

AU - Kowalski, Thomas E.

AU - Kumbhari, Vivek

AU - Singh, Vikesh K.

AU - Khashab, Mouen A.

PY - 2020/3/1

Y1 - 2020/3/1

N2 - Backgrounds â Endoscopic ultrasound (EUS)-guided placement of lumen-apposing metal stents (LAMSs) has gained popularity for the treatment of pancreatic walled-off necrosis (WON). We compared the 20-mm and 15-mm LAMSs for the treatment of symptomatic WON in terms of clinical success and adverse events. Methods â We conducted a retrospective, case-matched study of 306 adults at 22 tertiary centers from 04/2014 to 10/2018. A total of 102 patients with symptomatic WON who underwent drainage with 20-mm LAMS (cases) and 204 patients who underwent drainage with 15-mm LAMS (controls) were matched by age, sex, and drainage approach. Conditional logistic regression analysis was performed to compare clinical success (resolution of WON on follow-up imaging without reintervention) and adverse events (according to American Society for Gastrointestinal Endoscopy criteria). Results â Clinical success was achieved in 92.2âŠ% of patients with 20-mm LAMS and 91.7âŠ% of patients with 15-mm LAMS (odds ratio 0.92; P âŠ=âŠ0.91). Patients with 20-mm LAMS underwent fewer direct endoscopic necrosectomy (DEN) sessions (mean 1.3 vs. 2.1; P âŠ<âŠ0.001), despite having larger WON collections (transverse axis 118.2 vs. 101.9âŠmm, P âŠ=âŠ0.003; anteroposterior axis 95.9 vs. 80.1âŠmm, P âŠ=âŠ0.01). There was no difference in overall adverse events (21.6âŠ% vs. 15.2âŠ%; P âŠ=âŠ0.72) and bleeding events (4.9âŠ% vs. 3.4âŠ%; P âŠ=âŠ0.54) between the 20-mm and 15-mm LAMS groups, respectively. Conclusions â The 20-mm LAMS showed comparable clinical success and safety profile to the 15-mm LAMS, with the need for fewer DEN sessions for WON resolution.

AB - Backgrounds â Endoscopic ultrasound (EUS)-guided placement of lumen-apposing metal stents (LAMSs) has gained popularity for the treatment of pancreatic walled-off necrosis (WON). We compared the 20-mm and 15-mm LAMSs for the treatment of symptomatic WON in terms of clinical success and adverse events. Methods â We conducted a retrospective, case-matched study of 306 adults at 22 tertiary centers from 04/2014 to 10/2018. A total of 102 patients with symptomatic WON who underwent drainage with 20-mm LAMS (cases) and 204 patients who underwent drainage with 15-mm LAMS (controls) were matched by age, sex, and drainage approach. Conditional logistic regression analysis was performed to compare clinical success (resolution of WON on follow-up imaging without reintervention) and adverse events (according to American Society for Gastrointestinal Endoscopy criteria). Results â Clinical success was achieved in 92.2âŠ% of patients with 20-mm LAMS and 91.7âŠ% of patients with 15-mm LAMS (odds ratio 0.92; P âŠ=âŠ0.91). Patients with 20-mm LAMS underwent fewer direct endoscopic necrosectomy (DEN) sessions (mean 1.3 vs. 2.1; P âŠ<âŠ0.001), despite having larger WON collections (transverse axis 118.2 vs. 101.9âŠmm, P âŠ=âŠ0.003; anteroposterior axis 95.9 vs. 80.1âŠmm, P âŠ=âŠ0.01). There was no difference in overall adverse events (21.6âŠ% vs. 15.2âŠ%; P âŠ=âŠ0.72) and bleeding events (4.9âŠ% vs. 3.4âŠ%; P âŠ=âŠ0.54) between the 20-mm and 15-mm LAMS groups, respectively. Conclusions â The 20-mm LAMS showed comparable clinical success and safety profile to the 15-mm LAMS, with the need for fewer DEN sessions for WON resolution.

UR - http://www.scopus.com/inward/record.url?scp=85080131538&partnerID=8YFLogxK

U2 - 10.1055/a-1096-3299

DO - 10.1055/a-1096-3299

M3 - Article

C2 - 32000275

AN - SCOPUS:85080131538

SN - 0013-726X

VL - 52

SP - 211

EP - 219

JO - Endoscopy

JF - Endoscopy

IS - 3

ER -

Endoscopic ultrasound-guided drainage of pancreatic walled-off necrosis using 20-mm versus 15-mm lumen-apposing metal stents: An international, multicenter, case-matched study

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