Results may reflect recall bias
The survey reveals “a significant divergence from the scientific evidence in how PEP techniques are used in routine clinical practice,” wrote Dr. Avila and colleagues. Several studies, including a randomized controlled trial, support the use of rectal NSAIDs as prophylaxis as patients at average risk of PEP, but less than half of respondents reported using it. The ASGE guidelines state that this treatment is “reasonable,” but do not advocate for it. “If appropriate, adopting a stronger stance in our practice guidelines may lead to further widespread use of rectal NSAIDs in this group of patients,” wrote Dr. Avila and colleagues.
Pancreatic duct stent placement is a difficult procedure to perform. The success rate in one British study was 51%, and a study of expert pancreaticobiliary endoscopists found a failure rate of 7%. It therefore may not be surprising that was used less often than rectal NSAIDs among respondents, according to the authors.
Dr. Avila and colleagues acknowledged that the survey’s low response rate could have introduced nonresponse bias into the findings. They also stated that the study may have been affected by selection and recall biases. The results thus may not be generalizable to other practice settings, they concluded.
The authors did not report any study funding or disclosures.
* This story was updated on 12/2/2019.
SOURCE: Avila P et al. Gastrointest Endosc. 2019 Nov 16. doi: 10.1016/j.gie.2019.11.013.