Response to letter to the editor

Dear editor,

Adverse events are captured more accurately during the conduct of a randomised trial1 than when an audit is performed and reported retrospectively.2 As observed in our study, the majority of adverse events were encountered beyond the 4-week time frame when the walled-off necrosis (WON) had (nearly) resolved. Buried stent syndrome was noted when the lumen-apposing metal stents were deployed in the proximal stomach, particularly the region of the gastric cardia. We did not observe any specific factors that could explain the reason for delayed bleeding in our patient cohort except that all patients had WON that was more than 60 mm in largest dimension with greater than 30% necrosis. After a change in the study protocol whereby the stents are now extracted at 4 weeks, provided the WON have resolved on cross-sectional imaging, we have not encountered any stent-related adverse events in our study...