Evidence map›Paper›PMID 39174029›Full record

ArticleBMJ open gastroenterology2024

Optimising the indications for biliary stent placement during endoscopic retrograde cholangiopancreatography: a quality improvement initiative to enhance patient care and reduce healthcare resource utilisation.

Suliman Alhaidari, Ibrahim Alzahrani, Manar Alhanaee, Alan Decanini, Mahmod Mohamed, Sergio Zepeda-Gomez, Pamela Mathura, Julie Zhang, Gurpal Sandha

Abstract read
In one paragraph

Article in BMJ open gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Suliman AlhaidariMedicine, University of Alberta Hospital, Edmonton, Alberta, Canada.
Ibrahim AlzahraniMedicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudia Arabia.
Manar AlhanaeeMedicine, University of Alberta Hospital, Edmonton, Alberta, Canada.
Alan DecaniniMedicine, University of Alberta Hospital, Edmonton, Alberta, Canada.
Mahmod MohamedMedicine, University of Alberta Hospital, Edmonton, Alberta, Canada.
Sergio Zepeda-GomezMedicine, University of Alberta Hospital, Edmonton, Alberta, Canada.ORCID 0000-0002-5342-016X
Pamela MathuraMedicine, University of Alberta Hospital, Edmonton, Alberta, Canada.
Julie ZhangAlberta Health Services, Edmonton, Alberta, Canada.
Gurpal SandhaMedicine, University of Alberta Hospital, Edmonton, Alberta, Canada gsandha@ualberta.ca.ORCID 0000-0002-8393-2086

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA retrospective chart audit was performed to review biliary stent utilisation from January 2020 to January 2021. Non-guideline-based stent insertion was identified in 16% of patients with common bile duct (CBD) stones presenting for endoscopic retrograde cholangiopancreatography (ERCP). To improve this knowledge-practice gap, a quality improvement (QI) intervention was devised and trialled.

aimTo synchronise clinical indications for biliary stent insertion in patients with CBD stones in accordance with published guidelines.

methodsUsing a QI pre-post study design, chart audits were completed and shared with the ERCP team (n=6). Indication for biliary stent insertion was compared to published guidelines assessed by two reviewers independently (

resultsA total of 661 patients (337 F), mean age 59±19 years (range 12-98 years), underwent 885 ERCPs during this postintervention period. Of 661 patients, 384 (58%) were referred for CBD stones. A total of 192 biliary stents (105 plastic, 85 metal) were placed during the first ERCP (192/661, 29%), as compared with the preintervention year (223/598, 37%, p=0.2). Furthermore, 13/192 stents (7%) were placed not in accordance with published guidelines (

conclusionsEducation with audit and feedback supported the closing of a knowledge-to-practice gap for biliary stent insertion during ERCP, especially in patients with CBD stones. This has resulted in a notable reduction of avoidable stent placements and additional follow-up ERCPs and an overall saving of healthcare resources.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeGallstonesQuality ImprovementStentsAdolescentAdultAgedAged, 80 and overChildFemaleHumansMaleMiddle AgedPatient Acceptance of Health CarePractice Guidelines as TopicRetrospective StudiesAUDITENDOSCOPIC RETROGRADE PANCREATOGRAPHYSTENTS

Identifiers

PMID39174029
PMCPMC11340697

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.