The role of co-axially placed double-pigtail stents within lumen-apposing metal stents in draining pancreatic fluid collections

Aburajab et al1 reported their recent experience with lumen-apposing metal stents (LAMSs) in the treatment of pancreatic pseudocysts (PPs). They described a decreasing tendency in cyst cavity infection after placing double-pigtail stents (DPSs) across LAMSs compared with those without DPSs. Moreover, several centers reported their experience in DPS placement through LAMSs while draining walled-off necrosis (WON), and DPS was supposed to prevent occlusion by impacting necrotic tissue.2-4 Because PPs have no necrotic component, the authors postulate that DPSs might play a role in holding back the large pieces of solid food material from entering the cavity, which may subsequently lead to infection.

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