# Endoscopic Ultrasound-Guided Lumen-Apposing Metal Stent Drainage in Benign Pancreatobiliary and Gastrointestinal Disease: Evolving Techniques and Clinical Outcomes

## TL;DR

This paper reviews how endoscopic ultrasound-guided metal stent drainage is being used to treat non-cancerous pancreatobiliary and gastrointestinal diseases with promising results.

## Contribution

The paper highlights the expanding use of lumen-apposing metal stents in benign conditions and summarizes evolving techniques and outcomes.

## Key findings

- EUS-guided drainage techniques using LAMSs show high technical and clinical success rates.
- These procedures are particularly beneficial for patients who are poor surgical candidates.
- Device innovations have improved procedural efficacy and safety in benign settings.

## Abstract

Interventional endoscopic ultrasound (EUS) has become a cornerstone in the management of malignant pancreatobiliary diseases, offering minimally invasive alternatives to traditional surgical approaches. More recently, accumulating evidence supports its expanding role in the treatment of benign pancreatobiliary conditions, including acute cholecystitis and pancreatitis, benign gastric outlet obstruction, and scenarios involving altered gastrointestinal anatomy. This narrative review provides an overview of key EUS-guided drainage techniques utilizing lumen-apposing metal stents (LAMSs) in benign settings. It focuses on procedures such as EUS-guided gallbladder drainage, drainage of abdominal collections, EUS-directed transgastric ERCP (EDGE), and EUS-gastroenterostomy. These interventions have demonstrated high technical and clinical success rates, favorable safety profiles, and expanding indications, particularly among patients who are poor surgical candidates. This review highlights evolving techniques, clinical outcomes, and the impact of device innovations on procedural efficacy and safety.