Pancreatitis Clinical Trial
Official title:
Computer Aided, Non-invasive, Acoustic Gastrointestinal Surveillance (AGIS) in Post-ERCP Pancreatitis (PEP)
In this study, the investigators aim to distinguish patients with Post-Endoscopic retrograde cholangiopancreatography (ERCP) Pancreatitis (PEP) vs. those without PEP based on difference in pre- vs. post-ERCP measurements of AGIS-derived intestinal rates (IR). Based on the clinical observation that many patients with PEP develop ileus following ERCP, the investigators hypothesize that patients who develop PEP will exhibit lower IR following ERCP, and therefore a larger difference in pre- vs. post-ERCP IR.
This will be a prospective case series in 100 patients presenting to Cedars Sinai Medical
Center who undergo Endoscopic retrograde cholangiopancreatography (ERCP).
The investigators will place the AGIS sensor on each patient enrolled in the study, 30
minutes prior to procedure. The investigators will continuously record AGIS acoustic signals
from T-30 minutes to the time that they leave the hospital, either on discharge from the
Post-Anesthesia Care Unit or discharge from hospitalization, with the option to discontinue
if clinically required or requested by the provider or patient. Acoustic signal will be
evaluated, and intestinal motility events will be calculated; however, this data will not be
used to make decisions regarding clinical care. Physicians and nurses will not be made aware
of the AbStats readings.These measurements are solely observational. Patients will be
managed according to standard-of-care practice.
Routinely, patients are kept in the post-operative unit after their procedure, for one hour.
Those with pain are examined by a physician and the decision is made to admit for
observation to monitor for complications of ERCP, or to discharge home. The patients who are
discharged home from procedure will be followed by telephone surveys every day for 2 days
post procedure to determine if they have developed symptoms suggestive of PEP. If so, they
will be asked to go to the closest urgent care or emergency department for further
evaluation. Those who are admitted for observations post procedure will be followed for
signs or symptoms of PEP which includes meeting 2 of 3 criteria: Abdominal pain,
amylase/lipase >3 times the upper limit of normal 24 hours after procedure, and/or imaging
consistent with pancreatitis.
The AGIS multi-sensor wireless abdominal monitoring system includes low profile acoustic
sensors that are applied to the anterior abdominal wall with Tegaderm and monitors sounds
emanating from the GI tract. The acoustic sensors continuously and non-invasively monitor
and capture audio signals representing GI and abdominal wall function. The captured data is
recorded in a synchronized manner from two sensors, each placed 3cm on either side of the
umbilicus.
After a patient's participation in the study is complete, the investigators will analyze the
AbStats readings and the their clinical outcomes to observe if correlations exist between
patients with lower intestinal rates and those who develop PEP.
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Observational Model: Case-Only, Time Perspective: Prospective
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