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Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial
BACKGROUND: Before performing endoscopy to remove prophylactic pancreatic stents placed in patients with high risk of post‐endoscopic retrograde cholangiopancreatography pancreatitis (PEP), X‐ray imaging is recommended to confirm the stents position in the pancreatic duct. OBJECTIVES: The aim of the...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259253/ https://www.ncbi.nlm.nih.gov/pubmed/33887119 http://dx.doi.org/10.1002/ueg2.12063 |
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author | Michael, Florian Alexander Gerber, Ludmilla Weiler, Nina Hunyady, Peter Marton Abedin, Nada de la Vera, Anna‐Lena Laguna Stoffers, Philipp Filmann, Natalie Zeuzem, Stefan Bojunga, Jörg Friedrich‐Rust, Mireen Dultz, Georg |
author_facet | Michael, Florian Alexander Gerber, Ludmilla Weiler, Nina Hunyady, Peter Marton Abedin, Nada de la Vera, Anna‐Lena Laguna Stoffers, Philipp Filmann, Natalie Zeuzem, Stefan Bojunga, Jörg Friedrich‐Rust, Mireen Dultz, Georg |
author_sort | Michael, Florian Alexander |
collection | PubMed |
description | BACKGROUND: Before performing endoscopy to remove prophylactic pancreatic stents placed in patients with high risk of post‐endoscopic retrograde cholangiopancreatography pancreatitis (PEP), X‐ray imaging is recommended to confirm the stents position in the pancreatic duct. OBJECTIVES: The aim of the present study was to investigate the feasibility of prophylactic pancreatic stent detection by transabdominal ultrasonography, to reduce the burden of X‐ray imaging, which is currently the golden standard. METHODS: All patients who received a pancreatic stent for PEP prophylaxis were included in the present prospective trial. First, stent position was determined by transabdominal ultrasonography. Afterwards, it was verified by X‐ray imaging. Retained stents were removed by esophagogastroduodenoscopy. Dislocated stents needed no further intervention. RESULTS: Fourty‐one patients were enrolled in this study. All prophylactic pancreatic stents were straight 6 cm long 5 Fr stents with external flap. All stents were removed between day 1 and 10 (median: 3 days) in all cases. In 34 of 41 cases (83.0%), the pancreatic stent was still in place on the day of examination. Twenty‐nine of 34 (85.3%) stents were detected correctly by transabdominal ultrasonography. Overlying gas prevented visualization of the pancreas in 3/41 (7.3%) cases. Sensitivity of sonographic detection of the stent was 93.5% (29/31). Six of seven stents were determined correctly as dislocated by ultrasonography. Here, specificity was 85.7%. A positive predictive value of 96.7% (29/30) was examined. The negative predictive value was 75.0% (6/8). CONCLUSION: Transabdominal ultrasonography detects the majority of prophylactic pancreatic stents. Thereby, it helps to identify patients with an indication for endoscopy sufficiently. X‐ray imaging could subsequently be omitted in about 70% of examinations, reducing the radiation exposure for the patient and the endoscopy staff. |
format | Online Article Text |
id | pubmed-8259253 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82592532021-07-12 Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial Michael, Florian Alexander Gerber, Ludmilla Weiler, Nina Hunyady, Peter Marton Abedin, Nada de la Vera, Anna‐Lena Laguna Stoffers, Philipp Filmann, Natalie Zeuzem, Stefan Bojunga, Jörg Friedrich‐Rust, Mireen Dultz, Georg United European Gastroenterol J Endoscopy BACKGROUND: Before performing endoscopy to remove prophylactic pancreatic stents placed in patients with high risk of post‐endoscopic retrograde cholangiopancreatography pancreatitis (PEP), X‐ray imaging is recommended to confirm the stents position in the pancreatic duct. OBJECTIVES: The aim of the present study was to investigate the feasibility of prophylactic pancreatic stent detection by transabdominal ultrasonography, to reduce the burden of X‐ray imaging, which is currently the golden standard. METHODS: All patients who received a pancreatic stent for PEP prophylaxis were included in the present prospective trial. First, stent position was determined by transabdominal ultrasonography. Afterwards, it was verified by X‐ray imaging. Retained stents were removed by esophagogastroduodenoscopy. Dislocated stents needed no further intervention. RESULTS: Fourty‐one patients were enrolled in this study. All prophylactic pancreatic stents were straight 6 cm long 5 Fr stents with external flap. All stents were removed between day 1 and 10 (median: 3 days) in all cases. In 34 of 41 cases (83.0%), the pancreatic stent was still in place on the day of examination. Twenty‐nine of 34 (85.3%) stents were detected correctly by transabdominal ultrasonography. Overlying gas prevented visualization of the pancreas in 3/41 (7.3%) cases. Sensitivity of sonographic detection of the stent was 93.5% (29/31). Six of seven stents were determined correctly as dislocated by ultrasonography. Here, specificity was 85.7%. A positive predictive value of 96.7% (29/30) was examined. The negative predictive value was 75.0% (6/8). CONCLUSION: Transabdominal ultrasonography detects the majority of prophylactic pancreatic stents. Thereby, it helps to identify patients with an indication for endoscopy sufficiently. X‐ray imaging could subsequently be omitted in about 70% of examinations, reducing the radiation exposure for the patient and the endoscopy staff. John Wiley and Sons Inc. 2021-04-22 /pmc/articles/PMC8259253/ /pubmed/33887119 http://dx.doi.org/10.1002/ueg2.12063 Text en © 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Endoscopy Michael, Florian Alexander Gerber, Ludmilla Weiler, Nina Hunyady, Peter Marton Abedin, Nada de la Vera, Anna‐Lena Laguna Stoffers, Philipp Filmann, Natalie Zeuzem, Stefan Bojunga, Jörg Friedrich‐Rust, Mireen Dultz, Georg Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial |
title | Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial |
title_full | Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial |
title_fullStr | Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial |
title_full_unstemmed | Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial |
title_short | Transabdominal ultrasonography to reduce the burden of X‐ray imaging in prophylactic pancreatic stent localization after ERCP—A prospective trial |
title_sort | transabdominal ultrasonography to reduce the burden of x‐ray imaging in prophylactic pancreatic stent localization after ercp—a prospective trial |
topic | Endoscopy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259253/ https://www.ncbi.nlm.nih.gov/pubmed/33887119 http://dx.doi.org/10.1002/ueg2.12063 |
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