{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T18:22:38Z","timestamp":1778869358232,"version":"3.51.4"},"reference-count":35,"publisher":"Georg Thieme Verlag KG","issue":"09","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n            Background Endoscopic transmural drainage (ETD) using double-pigtail stents (DPSs) is a well-established treatment for walled-off pancreatic necrosis (WON). This study aimed to compare outcomes in patients undergoing ETD with DPSs left indwelling versus those where stents were removed or migrated.<\/jats:p><jats:p>\n            Methods This retrospective multicenter cohort study included patients with WON who underwent ETD using DPSs between July 2001 and December 2019. The primary outcome was recurrence of a pancreatic fluid collection (PFC). Secondary outcomes were long-term complications and recurrence-associated factors. Competing risk regression analysis considered DPS removal or migration as time-varying covariates.<\/jats:p><jats:p>\n            Results Among 320 patients (median age 58; 36% women), DPSs were removed in 153 (47.8%), migrated spontaneously in 27 (8.4%), and remained indwelling in 140 (43.8%). PFC recurrence was observed in 57 patients (17.8%): after removal (n = 39; 25.5%); after migration (n = 4; 14.8%); in patients with indwelling DPSs (n = 14; 10.0%). In 25 patients (7.8%), drainage of recurrent PFC was indicated. Risk factors for recurrence were DPS removal or migration (hazard ratio [HR] 3.45, 95%CI 1.37\u20138.70) and presence of a disconnected pancreatic duct (HR 5.08, 95%CI 1.84\u201314.0).<\/jats:p><jats:p>\n            Conclusions Among patients who undergo ETD of WON, leaving DPSs in situ seems to lower the risk of recurrent fluid collections, without any long-term DPS-related complications. These results suggest that DPSs should not be routinely removed and can be safely left indwelling indefinitely.<\/jats:p>","DOI":"10.1055\/a-2307-7123","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T23:30:32Z","timestamp":1713310232000},"page":"676-683","source":"Crossref","is-referenced-by-count":11,"title":["Impact of long-term transmural plastic stents on recurrence after endoscopic treatment of walled-off pancreatic necrosis"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9969-019X","authenticated-orcid":false,"given":"Rogier P.","family":"Voermans","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pieter Jan F.","family":"de Jonge","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5068-8227","authenticated-orcid":false,"given":"David M","family":"de Jong","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6887-9064","authenticated-orcid":false,"given":"Pauline M. C.","family":"Stassen","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9804-0603","authenticated-orcid":false,"given":"Ivo G.","family":"Schoots","sequence":"additional","affiliation":[{"name":"Radiology, Erasmus MC University Medical Center, Rotterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5591-0499","authenticated-orcid":false,"given":"Robert C.","family":"Verdonk","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-5499","authenticated-orcid":false,"given":"Marco J.","family":"Bruno","sequence":"additional","affiliation":[{"name":"Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,5,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1098","DOI":"10.1016\/j.cgh.2011.08.026","article-title":"An assessment of the severity of interstitial pancreatitis","volume":"9","author":"VK Singh","year":"2011","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1055\/a-0588-5365","article-title":"Endoscopic management of acute necrotizing pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines","volume":"50","author":"M Arvanitakis","year":"2018","journal-title":"Endoscopy"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"S163","DOI":"10.1016\/j.ijsu.2015.12.038","article-title":"Necrotizing pancreatitis: A review of the 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Onnekink","year":"2022","journal-title":"Gastroenterology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S0140-6736(17)32404-2","article-title":"Endoscopic or surgical step-up approach for infected necrotising pancreatitis: a multicentre randomised trial","volume":"391","author":"S van Brunschot","year":"2018","journal-title":"Lancet"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1136\/gutjnl-2021-325632","article-title":"Comparison of lumen-apposing metal stents versus double-pigtail plastic stents for infected necrotising pancreatitis","volume":"72","author":"L Boxhoorn","year":"2023","journal-title":"Gut"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"E1639","DOI":"10.1055\/a-1243-0092","article-title":"Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis: systematic review and meta-analysis","volume":"8","author":"V Chandrasekhara","year":"2020","journal-title":"Endosc Int Open"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1136\/gutjnl-2017-315335","article-title":"Non-superiority of lumen-apposing metal stents over plastic stents for drainage of walled-off necrosis in a randomised trial","volume":"68","author":"JY Bang","year":"2019","journal-title":"Gut"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1097\/SLA.0000000000002082","article-title":"Impact of disconnected pancreatic duct syndrome on the endoscopic management of pancreatic fluid collections","volume":"267","author":"JY Bang","year":"2018","journal-title":"Ann Surg"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1080\/00365521.2017.1398346","article-title":"Endoscopic ultrasound-guided pancreatic fluid collections' transmural drainage outcomes in 100 consecutive cases of pseudocysts and walled off necrosis: a single-centre experience from the United 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Basha","year":"2021","journal-title":"Gut"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"1234","DOI":"10.1111\/den.14266","article-title":"Long-term transmural drainage of pancreatic fluid collections with double pigtail stents following lumen-apposing metal stent placement improves recurrence-free survival in disconnected pancreatic duct syndrome","volume":"34","author":"R Pawa","year":"2022","journal-title":"Dig Endosc"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1055\/a-1857-5600","article-title":"Long-term transmural plastic stenting after metal stent removal in disconnected pancreatic duct: is the debate over?","volume":"54","author":"SS Rana","year":"2022","journal-title":"Endoscopy"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1055\/a-1811-6811","article-title":"Prevention of pancreatic fluid collection recurrence after metal stent removal: plastic is not so fantastic!","volume":"54","author":"G 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Gkolfakis","year":"2021","journal-title":"Endoscopy"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1741","DOI":"10.1007\/s00464-020-07567-8","article-title":"The safety and efficacy of a new 20-mm lumen apposing metal stent (lams) for the endoscopic treatment of pancreatic and peripancreatic fluid collections: a large international, multicenter study","volume":"35","author":"A Anderloni","year":"2021","journal-title":"Surg Endosc"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"3395","DOI":"10.1111\/jgh.15658","article-title":"Drainage of pancreatic fluid collections using a lumen-apposing metal stent with an electrocautery-enhanced delivery system","volume":"36","author":"S Khan","year":"2021","journal-title":"J Gastroenterol Hepatol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"82","DOI":"10.4103\/eus.eus_7_19","article-title":"Lumen apposing metal stents in drainage of pancreatic walled-off necrosis, are they any better than plastic stents? A systematic review and meta-analysis of studies published since the revised Atlanta classification of pancreatic fluid collections","volume":"8","author":"BP Mohan","year":"2019","journal-title":"Endosc Ultrasound"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2307-7123.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T11:36:29Z","timestamp":1730806589000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2307-7123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,16]]},"references-count":35,"journal-issue":{"issue":"09","published-online":{"date-parts":[[2024,8,29]]},"published-print":{"date-parts":[[2024,9]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2307-7123","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4,16]]},"published":{"date-parts":[[2024,4,16]]}}}