Transenteric drainage of pancreatic-fluid collections with fully covered self-expanding metallic stents (with video)

Background: Drainage of pancreatic-fluid collections (PFCs) by using fully covered self-expanding metallic stents (CSEMSs) offers the option of providing a larger-diameter access fistula for drainage when compared with plastic stents. Objective: To evaluate the efficacy and safety of transenteric drainage of PFCs by using CSEMSs. Design: A prospective case series. Setting: A tertiary-referral center. Patients: Between January 2007 and September 2007, 18 patients underwent drainage of PFCs by using CSEMSs. Follow-up and final results were prospectively recorded until May 2008. Interventions: Placement of CSEMSs with a double-pigtail stent placed alongside (4 cases) or into the CSEMS (14 cases) to prevent migration. Main Outcome Measurements: The number of sessions and time to resolution of the PFCs. Results: A median of 1 session was required to achieve drainage (range 1-4) when using CSEMSs. Complications included superinfection (5), bleeding (2), and inner migration (1). A total of 17 of 18 patients (95%) responded successfully, with 14 patients (78%) achieving complete resolution of their PFC. The mean (+/- SD) time of follow-up until final resolution was 77 80 clays (range 15-310 clays). Conclusions: Placement of CSEMSs seems to offer an effective and safe alternative for the drainage of PFCs. A randomized controlled trial should be performed to compare this technique with plastic-stent drainage.