Predictors of non-compliance with post-procedure follow-up after endoscopic stent placement

Delay or absence of follow-up after luminal or pancreatobiliary stent placement can lead to adverse events. Few studies have investigated patient factors that impact compliance. The aim of this study was to identify patient-related predictors of compliance and non-compliance for luminal or pancreatobiliary stent removal at a single center.

Patients who underwent esophagogastroduodenoscopy, endoscopic ultrasound, and/or endoscopic retrograde cholangiopancreatography with temporary stent placement for disease from March 2020 to March 2024 were included. Compliance was defined as stent removal or imaging confirming stent passage within 6 months (plastic stents or any cystgastrostomy stents) or 12 months (metal biliary stents) of the index procedure. Social and demographic risk factors potentially associated with stent removal and non-compliance were analyzed.

One hundred fifty-one cases fit the inclusion criteria, of which 118 involved compliant patients (78%) and 33 (22%) involved non-compliant patients. Time to stent removal was 57 ± 43 days in the compliant group and 324 ± 156 days in the non-compliant group ( P < 0.001). Common procedure indications included pancreatitis-related complications (n = 61), biliary obstruction (n = 55), and bile leak (n = 35). Predictors of non-compliance included male sex (0.047), history of drug use (P = 0.033), and absence of a working phone number ( P = 0.017) or email address ( P = 0.003), electronic medical record access ( P < 0.001), or primary care provider ( P = 0.034) before the procedure.

Patient-specific risk factors for non-compliance of stent removal were identified. Patients with such risk factors may require extra education and communication efforts.