Lumen-apposing metal stents (with videos).

Abstract

BACKGROUND AND AIMS:

Lumen-apposing metal stents (LAMSs) are a novel class of devices that have expanded the spectrum of endoscopic GI interventions. LAMSs with their dumbbell configuration, short saddle length, and large inner luminal diameter provide favorable stent characteristics to facilitate anastomosis formation between the gut lumen and adjacent structures.

METHODS:

The MEDLINE database was searched through April 2021 for articles related to LAMSs by using additional relevant keywords such as "walled-off pancreatic necrosis," "pseudocysts," "pancreatic fluid collection," "cholecystitis," "gastroenterostomy," in addition to "endoscopic treatment" and "endoscopic management," among others.

RESULTS:

This technology review describes the full spectrum of LAMS designs and delivery systems, techniques for deployment, procedural outcomes, safety, training issues, and financial considerations.

CONCLUSIONS:

Although LAMSs were initially introduced for drainage of pancreatic pseudocysts and walled-off necrosis, the versatility of these devices has led to a variety of off-label uses including gallbladder drainage, enteric bypass with the creation of gastroenterostomies, and treatment of luminal GI strictures.

• Authors: Prepared by: ASGE TECHNOLOGY COMMITTEE, Ryan J Law, Vinay Chandrasekhara, Amit Bhatt, Juan Carlos Bucobo, Andrew P Copland, Kumar Krishnan, Nikhil A Kumta, Rahul Pannala, Mansour A Parsi, Erik F Rahimi, Monica Saumoy, Guru Trikudanathan, Arvind J Trindade, Julie Yang, David R Lichtenstein
• Journal: Gastrointestinal endoscopy (Gastrointest Endosc) Vol. 94 Issue 3 Pg. 457-470 (09 2021) ISSN: 1097-6779 [Electronic] United States
• PMID: 34311975 (Publication Type: Practice Guideline)
• Copyright: Copyright © 2021 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Topics

• Drainage
• Endosonography
• Gallbladder
• Humans
• Pancreatic Pseudocyst
• Pancreatitis, Acute Necrotizing
• Stents
• Treatment Outcome