Adherence to ESGE guidelines on biliary stenting in malignant distal strictures: Results from a prospective Italian registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background and study aims: Distal malignant biliary strictures (dMBSs) are a common indication for endoscopic retrograde cholangiopancreatography (ERCP). The present study aimed to evaluate adherence of Italian endoscopic centers to European Society of Gastrointestinal Endoscopy (ESGE) guidelines on management of dMBS. Patients and methods: This prospective cohort, observational, multicenter study was promoted by the Italian Society of Digestive Endoscopy. All consecutive patients with dMBS were included in the registry. Clinical and technical data were recorded. Clinical follow-up was performed at 7 and 30 days, and then every 3 months. Adherence to the eight ESGE recommendations (defined as full-, intermediate- and poor-adherence if > 85%, ≥ 65% to ≤85%, and < 65%, respectively) was considered the primary outcome. Results: Seventeen Italian endoscopy centers were included. Between January 2020 and January 2022, 827 patients were included. Full adherence to the guidelines was reported for post-ERCP acute pancreatitis prophylaxis, retreatments, and preoperative biliary drainage. Intermediate adherence was reported for type of stent used in palliative drainage (85% SEMS and 15% plastic stents). Poor adherence was reported for type of stent used in preoperative drainage (56% self-expandable metal stents [SEMSs]), availability of pathological diagnosis in case of U-SEMS placement (45% of U-SEMSs placed without pathologically diagnosis), antibiotic prophylaxis (70.6%), and sphincterotomy (88%). Conclusions: Adherence to ESGE guidelines needs to be improved in specific areas, including excessive use of plastic stents, use of U-SEMS without pathological diagnosis, and routine performance of sphincterotomy and use of antibiotic prophylaxis. (ClinicalTrials.gov ID: NCT05761496).
Source: Endoscopy International Open
DOI: 10.1055/a-2777-9199
Authors: Tommaso Schepis, Rocco Maurizio Zagari, Stefano Francesco Crinó, Marco Sacco, Enrico Palmeri, Roberto Grassia, Alessio Santagati, Giovanna Venezia, Nicola Olivari, Alba Panarese, Massimiliano Mutignani, Ivano Biviano, Helga Bertani, Massimo Devani, Samuele de Minicis, Giuseppe de Roberto, Antonio Aucello, Socrate Pallio, Armando Gabbrielli, Sebastian Manuel Milluzzo, Maria Caterina Parodi, Luigi Pasquale, Guido Costamagna, Elton Dajti, Andrea Tringali, and the PROTESIED Study Group
Institutions: Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, University of Bologna, University of Verona, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Azienda Socio Sanitaria Territoriale di Cremona, Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo, Fondazione Poliambulanza Istituto Ospedaliero, University of Bari Aldo Moro, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Ospedale Santa Maria alle Scotte, Azienda Ospedaliero-Universitaria di Modena, Aziende Socio Sanitaria Territoriale Rhodense, European Institute of Oncology, Azienda Ospedaliera Universitaria Policlinico "G. Martino", Ospedale Santa Chiara, Ospedale Policlinico San Martino
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,825
OpenAlex ID: W7116982049
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