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Safe removal of lumen-apposing metal stent using argon plasma coagulation after EUS-guided cyst gastrostomy (with video).

ABSTRACT:

SUBMITTER: Miwa H

PROVIDER: S-EPMC8411564 | biostudies-literature |

REPOSITORIES: biostudies-literature

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EUS-guided stent removal in buried lumen-apposing metal stent syndrome: a case series.

Project description:Background and aimsLumen-apposing metal stents (LAMSs) play an increasing role in transgastric and transduodenal drainage of pancreatic fluid collections and allow novel EUS-guided interventions. Alongside the main adverse events of bleeding and occlusion, LAMSs can be overgrown by mucosa, which leads to the inability to visualize the stent in endoscopy.MethodsWe describe a series of 4 cases of buried LAMSs that were removed under EUS guidance for identification of the stent followed by removal with rat-tooth forceps.ResultsThe median in situ time of the LAMSs in the reported 4 cases was 53 days. All stents could no longer be visualized endoscopically when drainage of necrosis was complete. All 4 buried LAMSs could be identified by EUS and were removed successfully with forceps. In 1 case, balloon dilation of the stent tract was performed before stent removal. No adverse events were observed after the procedure.ConclusionsBuried stent syndrome is a rare adverse event of LAMSs. Here we describe a safe and effective approach for stent identification and removal without prior mucosal dissection.

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EUS-guided choledochoduodenostomy using a lumen-apposing metal stent in a patient with preexisting duodenal stent and ascites.

Project description:Video 1EUS-guided choledochoduodenostomy using a lumen-apposing metal stent in a patient with preexisting duodenal stent and ascites.

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Helix tack for lumen-apposing metal stent fixation in single-session EUS-directed transgastric ERCP

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EUS-guided drainage of a 20-cm biloma by use of a lumen-apposing metal stent.

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Safety of EUS-guided gallbladder drainage using a lumen-apposing metal stent in patients requiring anticoagulation.

Project description:Background and aimsEUS-guided gallbladder drainage (EUS-GBD) can be used to treat acute cholecystitis in patients with medical comorbidities that prevent definitive operative management. Historically, nonsurgical management of cholecystitis was achieved by way of percutaneous gallbladder drainage.MethodsWe examined the periprocedural bleeding rate of EUS-GBD for acute cholecystitis using lumen-apposing metal stents in 5 high-surgical-risk patients requiring anticoagulation. Data on 5 nonoperative candidates with acute cholecystitis who underwent EUS-GBD were studied retrospectively.ResultsThere were no immediate or delayed postprocedure adverse events, including bleeding.ConclusionsAlthough further study is needed, EUS-GBD appears safe in patients who require periprocedural anticoagulation.

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