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Sphincterotomy with FCSEMS (SPHINX): a monumental answer or the beginning of new mysteries?
  1. Mohan Ramchandani1,
  2. Aniruddha Pratap Singh1,
  3. Rupjyoti Talukdar1,
  4. D Nageshwar Reddy2
  1. 1Medical Gastroenterology, AIG Hospitals, Hyderabad, Telangana, India
  2. 2Chairman & Chief of Gastroenterology, AIG Hospitals, Hyderabad, Telangana, India
  1. Correspondence to Dr Mohan Ramchandani; ramchandanimohan{at}gmail.com

https://doi.org/10.1136/gutjnl-2024-334224

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    We read with interest the recently published randomised controlled trial (RCT) ‘SPHINX’,1 addressing the role of endoscopic sphincterotomy (ES) with fully covered s metal stent (FCSEMS) placement in preventing post-ERCP pancreatitis (PEP). Although this is the largest RCT on the topic, several concerns warrant discussion.

    Published data report variable rates of PEP after SEMS ranging from 0% to 26.8%,2–4 with lot of heterogeneity regarding the PEP preventive measures. Nevertheless severe pancreatitis remains rare. To assess the impact of ES a larger sample size will be required.

    The SPHINX trial sample …

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    Footnotes

    • X @AniruddhaGI

    • Contributors The idea for the article: Dr DNR and Dr MR. Literature search: Dr MR, Dr APS and Dr RT. Writing of the Article: Dr MR, Dr APS and Dr RT. Guarantor: Dr MR (Director, Interventional Endoscopy).

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.