Abstract
Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Büchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 978-985 |
| Number of pages | 8 |
| Journal | HPB |
| Volume | 19 |
| Issue number | 11 |
| DOIs | |
| State | Published - Nov 1 2017 |
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ASJC Scopus subject areas
- Hepatology
- Gastroenterology
Cite this
Diagnosis and treatment in chronic pancreatitis : an international survey and case vignette study. / Issa, Yama; van Santvoort, Hjalmar C.; Fockens, Paul; Besselink, Marc G.; Bollen, Thomas L.; Bruno, Marco J.; Boermeester, Marja A.; Moody, Frank G.; Bertrand, Claude; Johnson, Colin; van Lander, Aude; Carter, Ross; Conneely, John B.; Berrevoet, Frederik; Sousa Silva, Donzília; Li, Zong Fang; Lévy, Philippe; Oppong, Kofi; Gardner, Timothy B.; Wilcox, C. Mel; French, Jeremy; Steer, Michael; Bradley, Edward L.; Layer, Peter; Napoleon, Bertrand; Mosquera, Jorge Antonio; Gouma, D. J.; Andersson, Roland; Manzelli, Antonio; Klaase, J. M.; Falconi, Massimo; de-Madaria, Enrique; Casadei, Riccardo; Malleo, Giuseppe; Pezzilli, Raffaele; Malecka-Panas, Ewa; Lohr, Matthias; Mayerle, Julia; Rauws, Erik A.J.; Freeman, Martin L.; Ariffin, Affirul Chairil; Vasavada, Bhavin; Lai, Paul Bo San; Beristain-Hernandez, Jose Luis; Juan, Álvarez; Plaudis, Haralds; Vrochides, Dionisios; Neri, Vincenzo; Velayutham, Vimalraj; Andrianov, Aleksey; Figueras, Joan; Soreide, Kjetil; Shcherba, Aliaksei; Gachabayov, Mahir; Keith, Roger G.; Tsoulfas, Georgios; Fink, Michael Anthony; Crippa, Stefano; Nikfarjam, Mehrdad; Bora, Dibyajyoti; Desai, Rajendra; Donati, Marcello; Bong, Jan Jin; Martínez Moneo, Emma; Morris-Stiff, Gareth; Coker, Ahmet; de Resende, Alexandre Prado; Bhalerao, Suryabhan Sakhahari; Sikora, Sadiq S.; Kelemen, Dezső; Czakó, László; Ramesh, Hariharan; Rummo, Oleg; Fedaruk, Aliaksei; Shcherba, Aliaksei; Hlinnik, Alexey; Chinthakindi, Madhusudhan; Dumitrascu, Traian; Egorov, Vyacheslav; Bettschart, Vincent; Molinari, Michele; Guillermo, E. Aldana D.; Orloff, Susan; Kostov, Daniel Vasilev; Sulpice, Laurent; Knowles, Brett; Kimura, Yasutoshi; Marangoni, Gabriele; Joshi, Rajeev; Gyökeres, Tibor; Bedin; Vladimir, V.; Ivanecz, Arpad; Antonucci, Adelmo; Omoshoro-Jones, Jones A.O.; Nakache, Richard; Del Chiaro, Marco; Johnstone, Marianne; Saito, Tomoaki; Balzano, Gianpaolo; Egorov, Vyacheslav; Chooklin, Serge; Boraschi, Piero; Park, Walter; Pereira, Pedro Nuno Valente Reis; Pagano, Nico; Lykoudis, Pavlos; Partecke, Lars Ivo; Siatkouski, Aliaksandr; Martín, Rosa Jorba; Kawabata, Yasunari; Lourenço, Luís Carvalho; Marra-Lopez, Carlos; Lee, Jun Kyu; Habbe, Nils; Verdonk, Robert C.; Rabotyagova, Yliya; Talukdar, Rupjyoti; Frulloni, Luca; Galeev, Shamil; Berger, Zoltán; Yasuda, Takeo; Hackert, Thilo; Saatov, Ziyovuddin; Raptis, Dimitri Aristotle; Boadas, Jaume; Vitali, Francesco; Archibugi, Livia; Ryska, Miroslav; Tihanyi, Balazs; Singh, Vikesh K.; Masamune, Atsushi; Yeaton, Paul; Smith, Kerrington D.; Modi, Shrey; Cosen-Binker, Laura; Barreto, Savio George; Morandi, Eugenio; Valeri, Sergio; Morioka, Cintia Yoko; Lara, Luis F.; Takeyama, Yoshifumi; Gress, Frank G.; Yu, Young Dong; Gaia, Ezio; Barbu, Sorin Traian; İnce, Ali Tüzün; Deeprasertvit, Akkraporn; Chang, Yu Ting; Abiola, Stephen Olusola; Kacar, Sabite; Muscarella, Peter; Braat, Henri; Han, Samuel; Aghdassi, Ali A.; Frossard, Jean Louis; Smith, Jill P.; Schwartz, M. P.; van Dullemen, H. M.; Venneman, N. G.; Spanier, B. W.M.; Kuiken, Sjoerd; van Geenen, Erwin; Beilman, Greg; Papachristou, Georgios; Chapa Azuela, Oscar; van der Schaar, P.; Oruc, Nevin; Anten, Marie Paule; Nealon, William H.; García-Cano, Jesús; Jovani, Manol; Melki, Ziad; Ibrahim, Mustafa Mohammed Ahmed; Awajdarip, M. U.; Azam, Mohammad; Sabu, K. G.; Ermolaev, Igor; Shetty, Shiran; Oana, Belei; Pokrotnieks, Juris; Lazuchiewicz-Kot, Malgorzata; Bouali, Riadh; Winiarski, Marek; Schmitt, Marcus; Rimbas, Mihai; Meining, Alexander; Erwan, Bories; Meier, Peter N.; Schoefl, Rainer; Altonbary, Ahmed Youssef; Marsteller, Igor; Wallstabe, Ingo; Prifti, Skerdi; Lemmers, Arnaud; Horvath, M.; Kumar, Ajay; Palermo, Joseph J.
In: HPB, Vol. 19, No. 11, 01.11.2017, p. 978-985.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Diagnosis and treatment in chronic pancreatitis
T2 - an international survey and case vignette study
AU - Issa, Yama
AU - van Santvoort, Hjalmar C.
AU - Fockens, Paul
AU - Besselink, Marc G.
AU - Bollen, Thomas L.
AU - Bruno, Marco J.
AU - Boermeester, Marja A.
AU - Moody, Frank G.
AU - Bertrand, Claude
AU - Johnson, Colin
AU - van Lander, Aude
AU - Carter, Ross
AU - Conneely, John B.
AU - Berrevoet, Frederik
AU - Sousa Silva, Donzília
AU - Li, Zong Fang
AU - Lévy, Philippe
AU - Oppong, Kofi
AU - Gardner, Timothy B.
AU - Wilcox, C. Mel
AU - French, Jeremy
AU - Steer, Michael
AU - Bradley, Edward L.
AU - Layer, Peter
AU - Napoleon, Bertrand
AU - Mosquera, Jorge Antonio
AU - Gouma, D. J.
AU - Andersson, Roland
AU - Manzelli, Antonio
AU - Klaase, J. M.
AU - Falconi, Massimo
AU - de-Madaria, Enrique
AU - Casadei, Riccardo
AU - Malleo, Giuseppe
AU - Pezzilli, Raffaele
AU - Malecka-Panas, Ewa
AU - Lohr, Matthias
AU - Mayerle, Julia
AU - Rauws, Erik A.J.
AU - Freeman, Martin L.
AU - Ariffin, Affirul Chairil
AU - Vasavada, Bhavin
AU - Lai, Paul Bo San
AU - Beristain-Hernandez, Jose Luis
AU - Juan, Álvarez
AU - Plaudis, Haralds
AU - Vrochides, Dionisios
AU - Neri, Vincenzo
AU - Velayutham, Vimalraj
AU - Andrianov, Aleksey
AU - Figueras, Joan
AU - Soreide, Kjetil
AU - Shcherba, Aliaksei
AU - Gachabayov, Mahir
AU - Keith, Roger G.
AU - Tsoulfas, Georgios
AU - Fink, Michael Anthony
AU - Crippa, Stefano
AU - Nikfarjam, Mehrdad
AU - Bora, Dibyajyoti
AU - Desai, Rajendra
AU - Donati, Marcello
AU - Bong, Jan Jin
AU - Martínez Moneo, Emma
AU - Morris-Stiff, Gareth
AU - Coker, Ahmet
AU - de Resende, Alexandre Prado
AU - Bhalerao, Suryabhan Sakhahari
AU - Sikora, Sadiq S.
AU - Kelemen, Dezső
AU - Czakó, László
AU - Ramesh, Hariharan
AU - Rummo, Oleg
AU - Fedaruk, Aliaksei
AU - Shcherba, Aliaksei
AU - Hlinnik, Alexey
AU - Chinthakindi, Madhusudhan
AU - Dumitrascu, Traian
AU - Egorov, Vyacheslav
AU - Bettschart, Vincent
AU - Molinari, Michele
AU - Guillermo, E. Aldana D.
AU - Orloff, Susan
AU - Kostov, Daniel Vasilev
AU - Sulpice, Laurent
AU - Knowles, Brett
AU - Kimura, Yasutoshi
AU - Marangoni, Gabriele
AU - Joshi, Rajeev
AU - Gyökeres, Tibor
AU - Bedin,
AU - Vladimir, V.
AU - Ivanecz, Arpad
AU - Antonucci, Adelmo
AU - Omoshoro-Jones, Jones A.O.
AU - Nakache, Richard
AU - Del Chiaro, Marco
AU - Johnstone, Marianne
AU - Saito, Tomoaki
AU - Balzano, Gianpaolo
AU - Egorov, Vyacheslav
AU - Chooklin, Serge
AU - Boraschi, Piero
AU - Park, Walter
AU - Pereira, Pedro Nuno Valente Reis
AU - Pagano, Nico
AU - Lykoudis, Pavlos
AU - Partecke, Lars Ivo
AU - Siatkouski, Aliaksandr
AU - Martín, Rosa Jorba
AU - Kawabata, Yasunari
AU - Lourenço, Luís Carvalho
AU - Marra-Lopez, Carlos
AU - Lee, Jun Kyu
AU - Habbe, Nils
AU - Verdonk, Robert C.
AU - Rabotyagova, Yliya
AU - Talukdar, Rupjyoti
AU - Frulloni, Luca
AU - Galeev, Shamil
AU - Berger, Zoltán
AU - Yasuda, Takeo
AU - Hackert, Thilo
AU - Saatov, Ziyovuddin
AU - Raptis, Dimitri Aristotle
AU - Boadas, Jaume
AU - Vitali, Francesco
AU - Archibugi, Livia
AU - Ryska, Miroslav
AU - Tihanyi, Balazs
AU - Singh, Vikesh K.
AU - Masamune, Atsushi
AU - Yeaton, Paul
AU - Smith, Kerrington D.
AU - Modi, Shrey
AU - Cosen-Binker, Laura
AU - Barreto, Savio George
AU - Morandi, Eugenio
AU - Valeri, Sergio
AU - Morioka, Cintia Yoko
AU - Lara, Luis F.
AU - Takeyama, Yoshifumi
AU - Gress, Frank G.
AU - Yu, Young Dong
AU - Gaia, Ezio
AU - Barbu, Sorin Traian
AU - İnce, Ali Tüzün
AU - Deeprasertvit, Akkraporn
AU - Chang, Yu Ting
AU - Abiola, Stephen Olusola
AU - Kacar, Sabite
AU - Muscarella, Peter
AU - Braat, Henri
AU - Han, Samuel
AU - Aghdassi, Ali A.
AU - Frossard, Jean Louis
AU - Smith, Jill P.
AU - Schwartz, M. P.
AU - van Dullemen, H. M.
AU - Venneman, N. G.
AU - Spanier, B. W.M.
AU - Kuiken, Sjoerd
AU - van Geenen, Erwin
AU - Beilman, Greg
AU - Papachristou, Georgios
AU - Chapa Azuela, Oscar
AU - van der Schaar, P.
AU - Oruc, Nevin
AU - Anten, Marie Paule
AU - Nealon, William H.
AU - García-Cano, Jesús
AU - Jovani, Manol
AU - Melki, Ziad
AU - Ibrahim, Mustafa Mohammed Ahmed
AU - Awajdarip, M. U.
AU - Azam, Mohammad
AU - Sabu, K. G.
AU - Ermolaev, Igor
AU - Shetty, Shiran
AU - Oana, Belei
AU - Pokrotnieks, Juris
AU - Lazuchiewicz-Kot, Malgorzata
AU - Bouali, Riadh
AU - Winiarski, Marek
AU - Schmitt, Marcus
AU - Rimbas, Mihai
AU - Meining, Alexander
AU - Erwan, Bories
AU - Meier, Peter N.
AU - Schoefl, Rainer
AU - Altonbary, Ahmed Youssef
AU - Marsteller, Igor
AU - Wallstabe, Ingo
AU - Prifti, Skerdi
AU - Lemmers, Arnaud
AU - Horvath, M.
AU - Kumar, Ajay
AU - Palermo, Joseph J.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Büchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.
AB - Background The aim of the study was to evaluate the current opinion and clinical decision-making process of international pancreatologists, and to systematically identify key study questions regarding the diagnosis and treatment of chronic pancreatitis (CP) for future research. Methods An online survey, including questions regarding the diagnosis and treatment of CP and several controversial clinical case vignettes, was send by e-mail to members of various international pancreatic associations: IHPBA, APA, EPC, ESGE and DPSG. Results A total of 288 pancreatologists, 56% surgeons and 44% gastroenterologists, from at least 47 countries, participated in the survey. About half (48%) of the specialists used a classification tool for the diagnosis of CP, including the Mayo Clinic (28%), Mannheim (25%), or Büchler (25%) tools. Overall, CT was the preferred imaging modality for evaluation of an enlarged pancreatic head (59%), pseudocyst (55%), calcifications (75%), and peripancreatic fat infiltration (68%). MRI was preferred for assessment of main pancreatic duct (MPD) abnormalities (60%). Total pancreatectomy with auto-islet transplantation was the preferred treatment in patients with parenchymal calcifications without MPD abnormalities and in patients with refractory pain despite maximal medical, endoscopic, and surgical treatment. In patients with an enlarged pancreatic head, 58% preferred initial surgery (PPPD) versus 42% initial endoscopy. In patients with a dilated MPD and intraductal stones 56% preferred initial endoscopic ± ESWL treatment and 29% preferred initial surgical treatment. Conclusion Worldwide, clinical decision-making in CP is largely based on local expertise, beliefs and disbeliefs. Further development of evidence-based guidelines based on well designed (randomized) studies is strongly encouraged.
UR - http://www.scopus.com/inward/record.url?scp=85027404919&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85027404919&partnerID=8YFLogxK
U2 - 10.1016/j.hpb.2017.07.006
DO - 10.1016/j.hpb.2017.07.006
M3 - Article
VL - 19
SP - 978
EP - 985
JO - HPB
JF - HPB
SN - 1365-182X
IS - 11
ER -