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Expert consensus on endoscopic papillectomy using a Delphi process.

Jeska A Fritzsche1, Paul Fockens1, Marc Barthet2

  • 1Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam Gastroenterology Endocrinology & Metabolism, Amsterdam, the Netherlands.

Gastrointestinal Endoscopy
|April 22, 2021
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Summary
This summary is machine-generated.

International experts reached consensus on 59% of statements regarding endoscopic management of papillary adenomas. Key agreements include diagnostic workup, surgical referral criteria, pancreatitis prevention, and follow-up protocols for papillary adenomas.

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Area of Science:

  • Gastroenterology
  • Endoscopic Surgery
  • Oncology

Background:

  • Optimal algorithms for endoscopic treatment of papillary adenomas remain undefined.
  • International expert consensus is needed to guide management.
  • A Delphi process was employed to assess and enhance expert concordance.

Purpose of the Study:

  • To evaluate the existing consensus among international experts on endoscopic papillectomy.
  • To develop further concordance on the management of papillary adenomas through a Delphi process.

Main Methods:

  • Fifty-two international experts participated in a three-round online survey.
  • Consensus was defined as agreement among at least 70% of participants.
  • Data collection occurred between August and December 2019.

Main Results:

  • Sixteen experts completed the process, achieving consensus on 47 of 79 statements (59%).
  • Agreed-upon practices include specific diagnostic workups, surgical referral for malignancy, pancreatitis prevention (NSAIDs, pancreatic stents), biliary stenting for complications, and 5-year follow-up.
  • Areas lacking consensus were identified for future research.

Conclusions:

  • This study represents a foundational step towards an international consensus algorithm for endoscopic papillary adenoma management.
  • A significant number of areas require further investigation and consensus building.
  • Future research should focus on the aspects where expert agreement was not achieved.