Re-evaluation of the role of lumen-apposing metal stents (LAMS) for pancreatic fluid collection drainage

We read with great interest the recent endoscopy news reported by Bang et al,1 discussing the lumen-apposing metal stents (LAMS) for pancreatic fluid collection (PFC) drainage. Patients with walled-off necrosis (WON) treated by using LAMS in their centre occurred a 50% (6/12) rate of adverse events including delayed bleeding (3/12), buried stent syndrome (2/12) and biliary stricture (1/12), which is higher than we expected on our experiences.

As the authors reported all three patients presented with severe bleeding were confirmed with pseudoaneurysms. But another data from Sharaiha et al2 showed that LAMS method was safe for PFC. In 124 patients with WON underwent endoscopic transmural drainage using LAMS, where only 2 patients developed an acute haemorrhage during direct endoscopic necrosectomy (DEN), not associated with stents, none of them developed buried LAMS syndrome or biliary strictures. LAMS caused some rare complication like small-bowel obstruction due to...