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There are currently no plastic pancreatic duct stents that have been designed for endoscopic ultrasonography (EUS)-guided placement. This study prospectively evaluated the feasibility and efficacy of a new, single-pigtail, plastic stent. Eight patients with main pancreatic duct stricture or stenotic pancreatojejunostomy underwent EUS-guided placement of the pancreatic duct stent. The stent was placed successfully in all cases (8/8). Treatment success was achieved in all cases (8/8). A mild adverse event associated with the procedure was observed in one patient but there were no other adverse events during a mean follow-up of 7.4 months. This new pancreatic duct stent appears to be feasible and effective for EUS-guided stenting. [ABSTRACT FROM AUTHOR]

Background and study aims: Recently, a novel fully covered and biflanged metal stent (BFMS) dedicated to the drainage of walled-off necrosis (WON) was developed. The aim of this study was to retrospectively evaluate the safety, efficacy, and cost performance of drainage of WON using the novel BFMS compared with a traditional plastic stent. Patients and methods: A total of 70 patients with symptomatic WON were treated under endoscopic ultrasound (EUS) guidance. Initial drainage was conducted using the single gateway technique with placement of one or more plastic stents or a single BFMS. If drainage was unsuccessful, direct endoscopic necrosectomy (DEN) was performed. Results: There were no statistically significant differences in rates of technical success, clinical success, and adverse events between plastics stents and BFMS, despite the size of WON in the BFMS group being significantly larger than that in the plastic stent group (105.6 vs. 77.1 mm; P=0.003). The mean procedure times for the first EUS-guided drainage and for re-intervention were significantly shorter in the BFMS group than in the plastic stent group (28.8±7.1 vs. 42.6±14.2, respectively, for drainage, P<0.001; and 34.9±8.5 vs. 41.8±7.6, respectively, for re-intervention, P< 0.001). There was no statistically significant difference in the total cost between plastic stent and BFMS use in the treatment of WON ($5352 vs. $6274; P=0.25). Conclusions: Plastic stents and BFMS were safe and effective for the treatment of WON. In particular, BFMS placement appeared to be preferable for initial EUS-guided drainage and additional reintervention (e.g. DEN) as it reduced the procedure time. Prospective randomized controlled trials are warranted. [ABSTRACT FROM AUTHOR]