Real-time transabdominal ultrasound-guided ERCP is feasible and effective in pregnancy: a case series
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Bibliographic record
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is commonly required in pregnancy for choledocholithiasis, however, radiation exposure is a major concern for patients. Real-time transabdominal (TA) ultrasound (US)-guided ERCP is a radiation-free technique that facilitates confirmation of biliary cannulation, equipment exchange and stone clearance. We present the largest Western case series of this modality in pregnancy and a review of the literature. Four pregnant adult patients were referred to our tertiary center with suspected or documented choledocholithiasis and underwent real-time TA US-guided ERCP. US was successfully used to confirm positioning of the guidewire and ductal clearance. Procedures were successful in all patients with resolution of clinical symptoms and no immediate procedural complications. Two patients suffered adverse events later in their pregnancy. Real-time TA US-guided ERCP is a technically feasible and effective modality that can be offered to obtain biliary access in a radiation-free fashion for specific subsets of pregnant patients with choledocholithiasis. Future studies are needed to confirm the safety of this technique.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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) | 0.002 | 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 it