Stent for EUS-Guided Peripancreatic Fluid Collection (PFC) Drainage Selection of Appropriate Stents for Endoscopic Ultrasound (EUS)-Guided Drainage Procedures 2.1. It also discusses the selection of suitable stents, including the plastic stent ( Figure 1), SEMS ( Figure 2), and LAMS ( Figure 3), for each EUS-guided intervention. This review focuses on the advantages and disadvantages of the currently available stents for EUS-guided drainage. Research on dedicated stents for interventional EUS is rapidly advancing with an increasing number of innovative and refined techniques. Furthermore, EUS-guided GB drainage using LAMSs or dedicated SEMSs with bidirectional anti-migratory flanges is not only safe and reliable for acute cholecystitis, but also improves the quality of life in patients who are barely fit for surgical treatment. Similarly, EUS-guided ductal drainage with a specially designed fully covered self-expandable metal stent (FCSEMS) or a partially covered SEMS (PCSEMS) can be beneficial for patients with failed ERCP, gastric outlet obstruction (GOO), or surgically altered anatomy. In fact, recent innovations, such as the lumen-apposing metal stents (LAMS) designed specifically for EUS-guided interventions with bidirectional anchoring flanges, have improved outcomes in patients who require drainage. EUS-guided drainage procedures play an important role in the management of peripancreatic fluid collections (PFC) and bile duct (BD) and pancreatic duct (PD) drainage in cases of failed endoscopic retrograde cholangiopancreatography (ERCP), gallbladder (GB) drainage, and entero-enteric anastomosis. Herein, the current status and problems of the available stents are reviewed, including the applicable indications, long-term clinical outcomes, comparison between each stent, and their future prospects.Įndoscopic ultrasound (EUS)-guided drainage procedures are potentially disruptive alternatives to invasive surgery thus, therapeutic strategies are undergoing a paradigm shift towards minimally invasive treatments, and a number of devices and techniques are being developed for easier and safer procedures. Furthermore, some important questions remain unaddressed, such as which stent improves clinical outcomes and safety in EUS-guided drainage. Although the field of dedicated stents for interventional EUS is rapidly advancing with increasing innovations, the debate on the most appropriate stent for EUS-guided drainage has resurfaced. EUS-guided GB drainage is also performed using dedicated stents in patients with acute cholecystitis who are not fit for surgery. Similarly, EUS-guided BD and PD drainage with specially designed stents can be beneficial for patients with failed ERCP due to an inaccessible papilla, gastric outlet obstruction, or surgically altered anatomy. In fact, EUS-guided drainage has emerged as the treatment of choice for the management of PFC, and recent innovations such as fully covered metal stents (including lumen-apposing metal stents) have improved outcomes in patients with walled-off necrosis. Specially designed stents and delivery systems for EUS-guided transluminal interventions allow various new applications and improve the efficacy and safety of these procedures. They play an important role in the management of pancreatic fluid collections (PFC) and bile duct (BD) and pancreatic duct (PD) drainage in cases of failed endoscopic retrograde cholangiopancreatography (ERCP) or gallbladder (GB) drainage. Endoscopic ultrasound (EUS)-guided interventions provide easy access to structures adjacent to the gastrointestinal tract, effectively targeting them for therapeutic purposes.
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