Dear Editor,
Lumen-apposing metal stents (LAMS) are increasingly used for endoscopic drainage of pancreatic fluid collections (PFCs).[1] It is hypothesized that the wider lumen and foreshortening characteristics of the LAMS facilitate better drainage of PFC contents and minimize adverse events such as peritoneal soiling and stent migration. Preliminary observations from an ongoing randomized trial comparing LAMS and plastic stents for PFC drainage suggest that removal of LAMS after more than 3–4 weeks postinsertion result in higher incidence of bleeding, buried stent syndrome and biliary obstruction.[2] These adverse events highlighted the importance of timely removal of LAMS.
In an attempt to minimize patients lost to follow-up and facilitate timely removal of LAMS (AXIOS, Boston Scientific Corporation, Natick, MA, USA), a new App termed “Stent Tracker” has been developed (Visible Health Inc., Austin, TX, USA). The App is free to download and is compatible with both iOS and Android devices [Figure 1]. Following placement of the LAMS, patient demographics, procedural details (PFC type drained, site of LAMS placement), and reintervention date are entered into the App using a secure, provider-specific, user identification name and password. The App is HIPAA (Health Insurance Portability and Accountability Act of 1996) compliant as patient information is protected by government-regulated privacy shield. In addition to enabling the endoscopist to track procedures by logging on to the App, users can subscribe to automated E-mails detailing the number of patients with indwelling stents and time elapsed since stent placement, which in turn facilitate timely recall of patients for LAMS removal.
Figure 1.
Images of the Stent Tracker app
We have previously reported on the usefulness of professional Apps as educational tools for endosonographers worldwide.[3] The novel stent tracker App is an extension of that application in the correct direction: it not only is a valuable clinical tool for patient management but also has the potential to facilitate research by serving as a HIPAA-compliant registry.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
REFERENCES
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- 2.Bang JY, Hasan M, Navaneethan U, et al. Lumen-apposing metal stents (LAMS) for pancreatic fluid collection (PFC) drainage: May not be business as usual. Gut. 2016 doi: 10.1136/gutjnl-2016-312812. pii: gutjnl-2016-312812. [DOI] [PMC free article] [PubMed] [Google Scholar]
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