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LAMS versus plastic stents for infected pancreatic walled off necrosis (WON): has the addition of the TENSION trial to the AXIOMA study eased the tension?
  1. Avinash Tiwari,
  2. Altaf Shah,
  3. Jaswinder Singh
  1. Gastroenterology Department, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu and Kashmir, India
  1. Correspondence to Dr Avinash Tiwari, Gastroenterology, SKIMS, Srinagar, Jammu and Kashmir, 190011, India; avinash.gmc{at}

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We read with interest a recently published comparative non-randomised study by Boxhoorn et al.1 The TENSION trial compared with the AXIOMA study found that when compared with double-pigtail plastic stents in patients with infected pancreatic walled off necrosis (WON), lumen opposing metallic stent (LAMS) did not reduce the need for endoscopic transluminal necrosectomy and the rate of bleeding complications were comparable. Infected pancreatic WON is the most common indication for drainage. It has always been a difficult task for gastroenterologist to choose between LAMS and plastic stents for drainage in order to achieve a better outcome. Though the study addressed an important gap in knowledge, the following points need to be addressed:

  1. The study does not include the size of the collection and debris content (%) of WON for both groups.2 LAMS is presumed to be better than multiple plastic stents, …

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  • Correction notice This article has been corrected since it published Online First. The author note has been removed and affiliation updated.

  • Contributors AT: writing–original draft, concept and revision of the manuscript. AS: critical revision of the manuscript for important intellectual content. JS: critical revision of the manuscript for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.