LAMS Choledochoduodenostomies: With or Without Coaxial Plastic Stent
LAMS Choledochoduodenostomies: With or Without Coaxial Plastic Stent
The aim of the study is to evaluate technical, clinical and safety outcomes of lumen-apposing
 metal stent (LAMS) with and without a coaxial double-pigtail plastic stent (DPS) in
 EUS-guided choledochoduodenostomies (CDS) for the management of biliary obstruction.
The introduction of specific biliary lumen-apposing metal stents (LAMS) represented a great
 technical improvement in EUS-guided transmural Biliary drainage (BD) of distal malignant
 biliary obstruction Data is still limited, but recent studies and reviews have been reported
 with acceptable technical and clinical success. However, some concerns exist regarding its
 safety, as secondary adverse events

 There are doubts concerning the possible benefits derived from the insertion of
 double-pigtail plastic stents (DPS) within the lumen-apposing metal stents (LAMS) in the
 EUS-guided choledochoduodenostomy (CDS). Our hypothesis is that adding a coaxial plastic
 stent may offer benefits in terms of safety in CDS.
Inclusion Criteria:

 -  Distal biliary strictures,

 -  A prior failed attempt at biliary drainage

 -  informed consent provided by the patient.

 Patient exclusion criteria were as follows:

 -  younger than age 18 years,

 -  coagulopathy (international normalized ratio >1.5, marked thrombocytopenia with a
 platelet count <50,000/mL, or patient on anticoagulation therapy),

 -  critical illness.