AB127. P103. Evaluation of new stent for EUS-guided pancreatic duct drainage: long-term follow-up outcome

Background: EUS-guided pancreatic duct drainage (EUS-PD) has been reported as an alternative for failed conventional endoscopic retrograde cholangiopancreatography (ERCP). However, there are few dedicated devices for EUS-PD. Recently, we have developed a new plastic stent dedicated for EUS-PD and have conducted a feasibility study to evaluate its efficacy. In the present study, we evaluated the long-term efficacy of this new plastic stent.

Methods: Thirty-two patients (62±15.2 years old, 16 men) with acute recurrent pancreatitis were treated at our institution using our recently developed 7Fr plastic stent between Aug. 2013 and Jan. 2018.

Results: The stent was placed successfully in all the patients (32/32) and clinical success was achieved in all the patients. Early adverse events occurred in 7 patients (21.8%). Two died of primary disease and 3 were lost to follow-up. The remaining 27 patients were followed up after initial EUS-PD for a median of 23 months (range, 1–43 months). Twenty-one patients required regular stent exchange (3 times; range, 1–12 times). Spontaneous stent dislodgement was observed in 6 patients without any symptoms. Four patients wanted the stent removed after 1 year of the initial intervention. Twelve (44%) patients had regular stent exchange even after 1 year of the initial intervention. Three patients converted to standard transpapillary pancreatic duct stenting by conventional ERCP. Nine (33%) patients had complete stent removal either intentionally or by spontaneous dislodgement without any symptoms.

Conclusions: The new plastic stent for EUS-PD allows not only short-term technical success but also long-term clinical success in the majority of patients evaluated in this study.