Efficacy and Safety of Lumen Apposing Metal Stents

Conditions

Biliary Obstruction

Brief summary

Endoscopic ultrasonography (EUS) has revolutioned the management of gastroenterological patients and is acquiring an increasingly important role. The development of specifically designed stents has significantly increased the technical and clinical success rate of the EUS-guided procedures, considerably reducing the rate of adverse events. Currently EUS has a prominent role in drainage of peripancreatic fluid collections and it represents an important therapeutic option for patients with distal malignant biliary obstruction, in which the ERCP fails, allowing the positioning of a transgastric or transbulbar lumen apposing metal stent (LAMS) to drain the biliary duct. Moreover, the EUS-guided gallbladder drainage of patients with high surgical risk and acute cholecystitis, which cannot be operated, is another important therapeutic indication. Our aim is to perform a multicentre retrospective analysis of all types of EUS drainage (gallbladder drainage, biliary drainage, peripancreatic fluid collection drainage) with the positioning of LAMS in order to evaluate the rate of technical and clinical success and to assess the safety profile of these procedures.

Binda C, Anderloni A, Fugazza A, Amato A, de Nucci G, Redaelli A, Di Mitri R, Cugia L, Pollino V, Macchiarelli R, Mangiavillano B, Forti E, Brancaccio ML, Badas R, Maida M, Sinagra E, Repici A, Fabbri C, Tarantino I.

2023-06-2930 citations

10.1016/j.gie.2023.06.054

EUS-guided choledochoduodenostomy for malignant distal biliary obstruction after failed ERCP: a retrospective nationwide analysis.

Fugazza A, Fabbri C, Di Mitri R, Petrone MC, Colombo M, Cugia L, Amato A, Forti E, Binda C, Maida M, Sinagra E, Repici A, Tarantino I, Anderloni A, i-EUS Group.

2022-01-0448 citations

10.1016/j.gie.2021.12.032

Definition of a hospital volume threshold to optimize outcomes after drainage of pancreatic fluid collections with lumen-apposing metal stents: a nationwide cohort study.

Facciorusso A, Amato A, Crinò SF, Sinagra E, Maida M, Fugazza A, Binda C, Coluccio C, Repici A, Anderloni A, Tarantino I, Fabbri C, i-EUS Group.

2021-12-1822 citations

10.1016/j.gie.2021.12.006

Interventions

DEVICELumen apposing metal stent (LAMS)

Stent positioning

Study design

Observational model

COHORT

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

No

Inclusion criteria

* Age ≥18 years * Patients with distal malignant common bile duct obstruction with failed ERCP * Patients with symptomatic peripancreatic fluid collections * Patients with acute cholecystitis who are unfit for surgery * Agree to receive follow up phone calls * Able to provide written informed consent

Exclusion criteria

* Coagulation and/or platelets hereditary disorders. * Pregnant women * Inability to sign the informed consent

Design outcomes

Primary

Measure	Time frame
Evaluate the rate of technical and clinical success of EUS drainage (gallbladder drainage, biliary drainage, peripancreatic fluid collection drainage) with the positioning of lumen apposing metal stents	6 years

Countries

Italy

Contacts

Primary ContactAndrea Anderloni, MD

andrea.anderloni@humanitas.it0039-02-82247308

Backup ContactAlessandro Fugazza, MD

alessandro.fugazza@humanitas.it0039-02-82247021

Outcome results

None listed