Impact of endoprosthesis type on inflammatory response in patients undergoing endoscopic drainage of pancreatic fluid collections

• Published in: Digestive endoscopy 2024-02, Vol.36 (2), p.195-202
• Main Authors: Bang, Ji Young, Wilcox, Charles Mel, Navaneethan, Udayakumar, Hawes, Robert, Varadarajulu, Shyam
• Format: Article
• Language: English
• Subjects: inflammatory response; lumen‐apposing metal stent; pancreatic fluid collection; plastic stent; walled‐off necrosis
• ISSN: 0915-5635; 1443-1661
• DOI: 10.1111/den.14565

Objective To study the impact of endoprosthesis type on inflammatory response in patients undergoing endoscopic ultrasound (EUS)‐guided drainage of pancreatic fluid collections (PFC). Methods Patients undergoing EUS‐guided PFC drainage and treated using lumen‐apposing metal stents (LAMS) or plastic endoprostheses constituted the study cohort. The primary outcome was the presence of systemic inflammatory response syndrome (SIRS) after index intervention. Secondary outcomes were persistent organ failure, new onset organ failure, duration of hospitalization, and treatment success. Results In all, 303 patients were treated using LAMS (n = 247) or plastic stents (n = 56). At 48 h postintervention, the presence of SIRS (25.0 vs. 14.2%, P = 0.047), new onset SIRS (10.0 vs. 1.8%, P = 0.017), and new organ failure (5.4 vs. 0.4%, P = 0.003) were significantly higher in the plastic stent cohort compared to LAMS. On multivariable logistic regression analysis, the use of plastic stents (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.2–6.0, P = 0.014), patients receiving high‐acuity care (OR 5.1, 95% CI 2.5–10.4, P