Lumen-apposing-metal stent misdeployment in endoscopic ultrasound-guided drainages:A systematic review focusing on issues and rescue management  

作　　者：Elia Armellini Flavio Metelli Andrea Anderloni Anna Cominardi Giovanni Aragona Michele Marini FabioPace 

机构地区：[1]Department of Gastroenterology,ASST-Bergamoest,Seriate 24068,Bergamo,Italy [2]Gastroenterology and Digestive Endoscopy Unit,Fondazione IRCCS Policlinico San Matteo,Pavia 27100,Italy [3]Department of Gastroenterology,“Guglielmo da Saliceto”Hospital,Piacenza 29121,Italy [4]Department of General Surgery,ASST-Bergamoest,Seriate 24068,Italy

出　　处：《World Journal of Gastroenterology》2023年第21期3341-3361,共21页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND The introduction of lumen-apposing metal stents(LAMS)for endoscopic ultrasound(EUS)-guided drainages has marked a turning point in the field of interventional ultrasound and it is gathering worldwide diffusion in different clinical settings.Nevertheless,the procedure may conceal unexpected pitfalls.LAMS misdeployment is the most frequent cause of technical failure and it can be considered a procedure-related adverse event when it hampers the conclusion of the planned procedure or results in significant clinical consequences.Stent misdeployment can be managed successfully by endoscopic rescue maneuvers to allow the completion of the procedure.To date,no standardized indication is available to guide an appropriate rescue strategy depending on the type of procedure or of misdeployment.AIM To evaluate the incidence of LAMS misdeployment during EUS-guided choledochoduodenostomy(EUS-CDS),gallbladder drainage(EUS-GBD)and pancreatic fluid collections drainage(EUS-PFC)and to describe the endoscopic rescue strategies adopted under the circumstance.METHODS We conducted a systematic review of the literature on PubMed by searching for studies published up to October 2022.The search was carried out using the exploded medical subject heading terms“lumen apposing metal stent”,“LAMS”,“endoscopic ultrasound”and“choledochoduodenostomy”or“gallbladder”or“pancreatic fluid collections”.We included in the review on-label EUS-guided procedures namely EUS-CDS,EUS-GBD and EUS-PFC.Only those publications reporting EUS-guided LAMS positioning were considered.The studies reporting a technical success rate of 100%and other procedure-related adverse events were considered to calculate the overall rate of LAMS misdeployment,while studies not reporting the causes of technical failure were excluded.Case reports were considered only for the extraction of data regarding the issues of misdeployment and rescue techniques.The following data were collected from each study:Author,year of publication,study design,study p

关 键 词：Lams misdeployment Endoscopic ultrasound-guided drainage Lams maldeployment Biliary drainage Gallbladder drainage Pancreatic fluid collections Lumen-apposing metal stents 

分 类 号：R656[医药卫生—外科学]