Comparative efficacy and safety of bi-flanged metal stents versus lumen-apposing metal stents for endoscopic drainage of pancreatic fluid collections: a systematic review and meta-analysis.
Muhammad Shahzil, Muhammad Hashim Faisal, Muhammad Hammad Khan et al.
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In 30 seconds
This systematic review and meta-analysis compared bi-flanged metal stents (BFMS) with lumen-apposing metal stents (LAMS) for endoscopic ultrasound-guided drainage of pancreatic fluid collections. Three comparative studies included 627 patients (329 treated with BFMS and 298 with LAMS). The pooled analysis found no significant differences in technical success (OR 1.16; 95% CI 0.55-2.43) or clinical success (OR 0.97; 95% CI 0.51-1.87). Recurrence, procedural burden and reported adverse events were also comparable, supporting the authors’ conclusion that either stent is a viable option.
Key findings
- Technical success did not differ significantly between BFMS and LAMS (OR 1.16; 95% CI 0.55-2.43).
- Clinical success was similar with BFMS and LAMS (OR 0.97; 95% CI 0.51-1.87).
- No differences were observed in walled-off necrosis recurrence, necrosectomy sessions or mean number of endoscopic procedures.
- Bleeding, infection, stent migration and stent occlusion or dysfunction were comparable between groups.
Why it matters
Both stent types are used to drain pancreatic fluid collections, but comparative evidence has been limited. This pooled analysis suggests that neither device showed a clear advantage in efficacy, procedural burden or safety across the included studies. The findings can inform consideration of stent options while highlighting that the available comparative evidence remains limited.
What to keep in mind
Only three comparative studies were included. The authors call for larger prospective studies to refine stent selection.