Self-expandable metal stents for endoscopic ultrasound-guided drainage of peripancreatic fluid collections

Endoscopic ultrasound (EUS)-guided transmural drainage has evolved as an important treatment modality for peripancreatic fluid collections (PFCs). Recently, self-expandable metal stents (SEMS) have been introduced as an alternative for the traditionally used double-pigtail plastic stents, for endoscopic drainage. Due to the larger diameter (>10 mm) of SEMS, a wide drainage opening can be created, with a potentially reduced risk of stent occlusion and associated complications, and a direct access route if endoscopic necrosectomy is indicated. The use of different types of SEMS has been reported in several case reports and small case series. Although the results of these studies seem promising, the available results to date are limited and need critical appraisal. Large prospective and randomized trials are needed to evaluate the efficacy and safety of the placement of SEMS for endoscopic drainage of PFCs.