The silence of the LAMS

We read with interest the single-center, retrospective study by Aburajab et al1 on EUS-guided lumen-apposing metal stents (LAMSs) for symptomatic pancreatic pseudocyst (PP) drainage. Technical success was achieved in 98% (46/47) of patients. An interim analysis of their initial 23 cases revealed high rates of cyst infection (4/23; 17.4%), which prompted them to routinely place a 10F double-pigtail (DP) stent across the LAMS in the remaining 23 cases. Overall, there was a trend toward a lower rate of infection in patients with DP through the LAMS versus LAMS alone (relative risk 0.8; 95% confidence interval, 0.7-1.0; P = .054).

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