Comparative study of EUS-guided transluminal drainage using a novel biflanged metal stent versus plastic stent for pancreatic fluid collections

Objective: Recently, a novel fully covered biflanged metal stent (BFMS) dedicated to EUS-guided transluminal drainage (EUS-TD) for pancreatic fluid collection (PFC) has been developed. The aim is to retrospectively evaluate the safety, efficacy and cost performance of EUS-TD using a novel BFMS compared with a traditional plastic stent (PS).Methods: One hundred eight patients with symptomatic PFC were treated. Initial EUS-TD was performed using one or more PS (n=41) or a BFMS (n=67). When EUS-TD was ineffective, direct endoscopic necrosectomy and/or additional endoscopic drainage were performed. Results: There were no statistically significant differences in technical success rate and adverse event rates between PS and BFMS groups. However, the final clinical success rate in BFMS group was significantly better than in PS group (87.8% vs. 98.5%, respectively; p=0.02). Mean procedure time of 1st EUS-TD and re-intervention was significantly shorter in BFMS group than PS group (28.8 vs. 42.6, respectively; p<0.001 and 34.9 vs. 41.8, respectively; p<0.001). There was no statistically significant difference in total cost between PS and BFMS groups ($5352 vs. $6274, p=0.25), but in complicated cases total cost tended to be higher in PS group than in BFMS group ($9875 vs. $7446, p=0.20). Conclusions: A novel BFMS is a useful and safe drainage device for EUS-TD for the treatment of PFC.