{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T03:35:38Z","timestamp":1783136138258,"version":"3.54.6"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Disconnected\u2009pancreatic duct syndrome (DPDS) is the most common cause of pancreatic fluid collection (PFC) recurrence. While long\u2010term transmural drainage with plastic stents is the preferred endoscopic approach, there is a paucity of literature on patients undergoing initial drainage with lumen\u2010apposing metal stents (LAMS). We describe our experience managing patients with DPDS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of a prospectively maintained database (November 2015\u2013September 2020) was performed looking at clinical outcomes and overall survival for patients undergoing endoscopic management of PFCs using LAMS. The primary outcome was to assess recurrence\u2010free survival in PFC patients with DPDS managed with or without double pigtail stents (DPS) replacement after LAMS removal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 96 patients with PFCs, 48 with DPDS were included in the study. The median follow\u2010up was 20.1\u2009months. LAMS replacement with DPS was successful in 21\/48 (43.8%) patients. Recurrence was seen in 1\/21 (5%) patients with DPS replacement and 10\/27 (37%) without DPS replacement. In multivariable models, a longer duration of LAMS placement was negatively associated with successful DPS replacement (odds ratio 1.33, 95% confidence interval [CI] 1.11, 1.59,\u2009<jats:italic>P<\/jats:italic>\u2009=\u20090.0019) and successful LAMS replacement with DPS in patients with DPDS improved recurrence\u2010free survival (hazard ratio 0.09, 95% CI 0.01, 0.83, <jats:italic>P<\/jats:italic>\u2009=\u20090.033).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with PFCs and DPDS, early replacement of LAMS with DPS improves the likelihood of successful long\u2010term transmural drainage and decreases recurrences.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.14266","type":"journal-article","created":{"date-parts":[[2022,2,11]],"date-time":"2022-02-11T17:33:54Z","timestamp":1644600834000},"page":"1234-1241","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":30,"title":["Long\u2010term transmural drainage of pancreatic fluid collections with double pigtail stents following lumen\u2010apposing metal stent placement improves recurrence\u2010free survival in disconnected pancreatic duct syndrome"],"prefix":"10.1111","volume":"34","author":[{"given":"Rishi","family":"Pawa","sequence":"first","affiliation":[{"name":"Department of Medicine Section\u00a0on Gastroenterology Wake Forest School of Medicine  Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Dorrell","sequence":"additional","affiliation":[{"name":"Department of Medicine Wake Forest School of Medicine  Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Russell","sequence":"additional","affiliation":[{"name":"Biostatistics and Data Science Wake Forest School of Medicine  Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gilliam","sequence":"additional","affiliation":[{"name":"Department of Medicine Section\u00a0on Gastroenterology Wake Forest School of Medicine  Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girish","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Medicine Section\u00a0on Gastroenterology Wake Forest School of Medicine  Winston\u2010Salem USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati","family":"Pawa","sequence":"additional","affiliation":[{"name":"Department of Medicine Section\u00a0on Gastroenterology Wake Forest School of Medicine  Winston\u2010Salem 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