A330 MANAGEMENT OF COMPLEX PANCREATIC FLUID COLLECTIONS USING THE NAGITM COVERED EXPANDABLE METAL STENT
Bibliographic record
Abstract
Covered self-expandable metallic stents (CSEMS) are a novel device designed for transmural drainage of symptomatic pancreatic fluid collections (PFC’s). Theoretical advantages over conventional double plastic pigtail stents are due to a larger luminal diameter optimizing drainage particularly in cases of walled of necrosis (WON). The aim of our study was to evaluate the efficacy and safety of a NAGITM stent in the management of PFC’S. This was a retrospective single center study. Between February 2015 and July of 2016, 17 patients underwent EUS guided PFC drainage using the NAGITM CSEMS. Primary endpoints included technical success (stent deployment), clinical success identified by radiographic resolution (PFC<2cm) and symptomatic resolution, stent related complications and rates of re-intervention. There were 17 patients (mean age: 53.5) with symptomatic PFC’s: 12 patients (71%) with WON and 5 (29%) with a simple pancreatic psuedocyst. The NAGITM stent was successfully placed via the transgastric approach in all 17 patients and left in situ for a median of 46 days (range 12–146). Endoscopic trans mucosal drainage was clinically successful in 100% of patients with pancreatic pseudocysts and 43% for WON. In the patients with WON, 58% (7/12) required additional necrosectomy and/or irrigation: 4 required one intervention and 3 required more than one intervention to achieve resolution. Major complications were identified in 2 of 17 patients secondary to PFC infection due to stent obstruction. Minor complications identified included self-limited bleeding secondary to tract puncture (n=1), transient fever (n=1) and possible reflux esophagitis secondary to stent malposition. Our study supports the literature that the CSEMS are an effective, and safe modality for the treatment of PFC’s. Future studies are needed to assess for superiority over conventional plastic stents and other existing FSCEMS particularly in the drainage of WON. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".