Interventional EUS using a lumen-apposing designed metal stent in pancreaticobiliary diseases

EUS-guided drainage for pancreatic fluid collection, acute cholecystitis and obstructive jaundice using tubular biliary plastic stent (TBPS) has become one of salvage therapy. Several reports describe the unexpected adverse events, e.g. poor drainage, bile leak, and stent migration due to TBPS. Recently, partially or fully covered self-expandable tubular metal stents has been used for interventional EUS to avoid TBPS-related complications. However, these tubular metal stents were designed for luminal recanalization and have significant shortcomings when used for transenteric drainage. Thus, in light of these potential limitations, a SEMS designed for transluminal drainage is needed. Lately, novel biflanged lumen-apposing metal stent (AXIOS, Xlumena Inc., Mountain View, CA, USA) has emerged for interventional EUS. In this session, we would like to introduce the efficacy and safety of this stent for interventional EUS for pancreaticobiliary disorders.