@article{0482e274e07748c180864c36a58d6079,
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.}",
note = "Funding Information: Drs.Arlt, Ellrichmann, Aparicio, Sejpal, Irani, Pawa, Ahmed, Sedarat, Hampe, Sharaiha, Berzin, Stevens, Willingham, Kushnir, Ngamrueng-phong, Hugget, Baron, Repici, Adler, Nasr, Kowalski, Kumbhari, and Khashab are consultants for Boston Scientific. Dr. Trindade is a consultant for Pentax Medical and CSA Medical. Dr. Benias is a consultant for Fujifilm, Medtronic, and Apollo. Dr. Sejpal is also a consultant for Olympus America. Dr. Ahmed is also a consultant for Cook Medical. Dr. Hampe is also a consultant for Cook Medical, Olympus America, and B. Braun. Dr. Sharaiha is also a consultant for Olympus America and Apollo. Dr. Chahal is a consultant for Medtronic. Dr. Willingham is also a consultant for RedPath, Cook Medical, Xlumena, Oncolys Bio-pharma, and has received research funding to the university from Cancer Prevention Pharmaceuticals. Dr. Hugget is also a consultant for Cook Medical. Dr. Repici has also received research funding from Boston Scientific. Dr. Kumbhari is also a consultant for Medtronic, Reshape Lifesciences, and Apollo Endosurgery, and has received research support from ERBE and Apollo Endosurgery. Dr. Singh is a consultant for Abbvie and Novo Nordisk, and is a member of an advisory board for Akcea. Dr. Khashab is also a consultant for Olympus America and Medtronic. All other authors have no conflict of interest to disclose. Publisher Copyright: {\textcopyright} 2020 Royal Society of Chemistry. All rights reserved.",
year = "2020",
month = mar,
day = "1",
doi = "10.1055/a-1096-3299",
language = "English (US)",
volume = "52",
pages = "211--219",
journal = "Endoscopy",
issn = "0013-726X",
publisher = "Georg Thieme Verlag",
number = "3",
}