Endoscopic necrosectomy of infected pancreatic Walled-Off Necrosis using two types of Lumen-Apposing Metal Stents
5 affiliations
- 1Department of Gastroenterology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China
- 2Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou, Zhejiang, China
- 3Hangzhou Institute of Digestive Diseases, Hangzhou, Zhejiang, China
- 4Zhejiang Provincial Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research, Hangzhou, Zhejiang, China
- 5Department of Gastroenterology, Olive View-UCLA Medical Center and David Geffen School of Medicine at UCLA, Los Angeles, California, United States of America
Abstract
Background: Lumen-apposing metal stent (LAMS) placement enables transmural drainage of walled-off necrosis (WON) with secure anchoring and provides endoscopic access for subsequent necrosectomy. This study compared the efficacy and safety of two commercially available LAMS designs (Hot-Axios vs. Micro-Tech) in patients with infected WON. Methods: We retrospectively reviewed patients with infected WON who underwent endoscopic ultrasound (EUS)-guided LAMS placement followed by endoscopic debridement at our center between August 2020 and June 2025. Results: Thirty-one patients were included (Hot-Axios, n = 21; Micro-Tech, n = 10). The overall necrosectomy success rate was 80.65% (25/31). Necrosectomy success was numerically higher with Hot-Axios than with Micro-Tech (85.71% vs. 70.00%), but the difference was not statistically significant (p = 0.358). There was a statistically significant difference in the incidence of complications between the two groups (P = 0.007); bleeding occurred more frequently in the Hot-Axios group (33.33% vs. 0%), whereas stent migration was more common in the Micro-Tech group (0% vs. 20.00%). Conclusions: In conclusion, endoscopic necrosectomy for infected WON using LAMS is feasible and effective. Hot-Axios may provide more secure fixation and better resistance to migration; however, it may carry a higher risk of bleeding.
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BibTeX
@article{ding2026endoscopic,
title = {{Endoscopic necrosectomy of infected pancreatic Walled-Off Necrosis using two types of Lumen-Apposing Metal Stents}},
author = {Cong Ding and Hui Wang and Yifeng Zhou and Jing Yang and Xia Wang and Goufan Shen and Xiaofeng Zhang and Richard Hu and Jianfeng Yang},
journal = {PLOS One},
year = {2026},
month = nov,
doi = {10.1371/journal.pone.0361859},
url = {https://doi.org/10.1371/journal.pone.0361859},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Endoscopic necrosectomy of infected pancreatic Walled-Off Necrosis using two types of Lumen-Apposing Metal Stents
AU - Cong Ding
AU - Hui Wang
AU - Yifeng Zhou
AU - Jing Yang
AU - Xia Wang
AU - Goufan Shen
AU - Xiaofeng Zhang
AU - Richard Hu
AU - Jianfeng Yang
PY - 2026
DA - 2026/11/03
JO - PLOS One
DO - 10.1371/journal.pone.0361859
UR - https://doi.org/10.1371/journal.pone.0361859
AB - Background: Lumen-apposing metal stent (LAMS) placement enables transmural drainage of walled-off necrosis (WON) with secure anchoring and provides endoscopic access for subsequent necrosectomy. This study compared the efficacy and safety of two commercially available LAMS designs (Hot-Axios vs. Micro-Tech) in patients with infected WON. Methods: We retrospectively reviewed patients with infected WON who underwent endoscopic ultrasound (EUS)-guided LAMS placement followed by endoscopic debridement at our center between August 2020 and June 2025. Results: Thirty-one patients were included (Hot-Axios, n = 21; Micro-Tech, n = 10). The overall necrosectomy success rate was 80.65% (25/31). Necrosectomy success was numerically higher with Hot-Axios than with Micro-Tech (85.71% vs. 70.00%), but the difference was not statistically significant (p = 0.358). There was a statistically significant difference in the incidence of complications between the two groups (P = 0.007); bleeding occurred more frequently in the Hot-Axios group (33.33% vs. 0%), whereas stent migration was more common in the Micro-Tech group (0% vs. 20.00%). Conclusions: In conclusion, endoscopic necrosectomy for infected WON using LAMS is feasible and effective. Hot-Axios may provide more secure fixation and better resistance to migration; however, it may carry a higher risk of bleeding.
SN - 1932-6203
ER -