Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study

Yama Issa; Hjalmar C. van Santvoort; Paul Fockens; Marc G. Besselink; Thomas L. Bollen; Marco J. Bruno; Marja A. Boermeester; Frank G. Moody; Claude Bertrand; Colin Johnson; Aude van Lander; Ross Carter; John B. Conneely; Frederik Berrevoet; Donzília Sousa Silva; Zong Fang Li; Philippe Lévy; Kofi Oppong; Timothy B. Gardner; C. Mel Wilcox; Jeremy French; Michael Steer; Edward L. Bradley; Peter Layer; Bertrand Napoleon; Jorge Antonio Mosquera; D. J. Gouma; Roland Andersson; Antonio Manzelli; J. M. Klaase; Massimo Falconi; Enrique de-Madaria; Riccardo Casadei; Giuseppe Malleo; Raffaele Pezzilli; Ewa Malecka-Panas; Matthias Lohr; Julia Mayerle; Erik A.J. Rauws; Martin L. Freeman; Affirul Chairil Ariffin; Bhavin Vasavada; Paul Bo San Lai; Jose Luis Beristain-Hernandez; Álvarez Juan; Haralds Plaudis; Dionisios Vrochides; Vincenzo Neri; Vimalraj Velayutham; Aleksey Andrianov; Joan Figueras; Kjetil Soreide; Aliaksei Shcherba; Mahir Gachabayov; Roger G. Keith; Georgios Tsoulfas; Michael Anthony Fink; Stefano Crippa; Mehrdad Nikfarjam; Dibyajyoti Bora; Rajendra Desai; Marcello Donati; Jan Jin Bong; Emma Martínez Moneo; Gareth Morris-Stiff; Ahmet Coker; Alexandre Prado de Resende; Suryabhan Sakhahari Bhalerao; Sadiq S. Sikora; Dezső Kelemen; László Czakó; Hariharan Ramesh; Oleg Rummo; Aliaksei Fedaruk; Aliaksei Shcherba; Alexey Hlinnik; Madhusudhan Chinthakindi; Traian Dumitrascu; Vyacheslav Egorov; Vincent Bettschart; Michele Molinari; E. Aldana D. Guillermo; Susan L. Orloff; Daniel Vasilev Kostov; Laurent Sulpice; Brett Knowles; Yasutoshi Kimura; Gabriele Marangoni; Rajeev Joshi; Tibor Gyökeres; Bedin; V. Vladimir; Arpad Ivanecz; Adelmo Antonucci; Jones A.O. Omoshoro-Jones; Richard Nakache; Marco Del Chiaro; Marianne Johnstone; Tomoaki Saito; Gianpaolo Balzano; Vyacheslav Egorov; Serge Chooklin; Piero Boraschi; Walter Park; Pedro Nuno Valente Reis Pereira; Nico Pagano; Pavlos Lykoudis; Lars Ivo Partecke; Aliaksandr Siatkouski; Rosa Jorba Martín; Yasunari Kawabata; Luís Carvalho Lourenço; Carlos Marra-Lopez; Jun Kyu Lee; Nils Habbe; Robert C. Verdonk; Yliya Rabotyagova; Rupjyoti Talukdar; Luca Frulloni; Shamil Galeev; Zoltán Berger; Takeo Yasuda; Thilo Hackert; Ziyovuddin Saatov; Dimitri Aristotle Raptis; Jaume Boadas; Francesco Vitali; Livia Archibugi; Miroslav Ryska; Balazs Tihanyi; Vikesh K. Singh; Atsushi Masamune; Paul Yeaton; Kerrington D. Smith; Shrey Modi; Laura Cosen-Binker; Savio George Barreto; Eugenio Morandi; Sergio Valeri; Cintia Yoko Morioka; Luis F. Lara; Yoshifumi Takeyama; Frank G. Gress; Young Dong Yu; Ezio Gaia; Sorin Traian Barbu; Ali Tüzün İnce; Akkraporn Deeprasertvit; Yu Ting Chang; Stephen Olusola Abiola; Sabite Kacar; Peter Muscarella; Henri Braat; Samuel Han; Ali A. Aghdassi; Jean Louis Frossard; Jill P. Smith; M. P. Schwartz; H. M. van Dullemen; N. G. Venneman; B. W.M. Spanier; Sjoerd Kuiken; Erwin van Geenen; Greg Beilman; Georgios Papachristou; Oscar Chapa Azuela; P. van der Schaar; Nevin Oruc; Marie Paule Anten; William H. Nealon; Jesús García-Cano; Manol Jovani; Ziad Melki; Mustafa Mohammed Ahmed Ibrahim; M. U. Awajdarip; Mohammad Azam; K. G. Sabu; Igor Ermolaev; Shiran Shetty; Belei Oana; Juris Pokrotnieks; Malgorzata Lazuchiewicz-Kot; Riadh Bouali; Marek Winiarski; Marcus Schmitt; Mihai Rimbas; Alexander Meining; Bories Erwan; Peter N. Meier; Rainer Schoefl; Ahmed Youssef Altonbary; Igor Marsteller; Ingo Wallstabe; Skerdi Prifti; Arnaud Lemmers; M. Horvath; Ajay Kumar; Joseph J. Palermo

doi:10.1016/j.hpb.2017.07.006

Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study

Yama Issa, Hjalmar C. van Santvoort, Paul Fockens, Marc G. Besselink, Thomas L. Bollen, Marco J. Bruno, Marja A. Boermeester, Frank G. Moody, Claude Bertrand, Colin Johnson, Aude van Lander, Ross Carter, John B. Conneely, Frederik Berrevoet, Donzília Sousa Silva, Zong Fang Li, Philippe Lévy, Kofi Oppong, Timothy B. Gardner, C. Mel WilcoxJeremy French, Michael Steer, Edward L. Bradley, Peter Layer, Bertrand Napoleon, Jorge Antonio Mosquera, D. J. Gouma, Roland Andersson, Antonio Manzelli, J. M. Klaase, Massimo Falconi, Enrique de-Madaria, Riccardo Casadei, Giuseppe Malleo, Raffaele Pezzilli, Ewa Malecka-Panas, Matthias Lohr, Julia Mayerle, Erik A.J. Rauws, Martin L. Freeman, Affirul Chairil Ariffin, Bhavin Vasavada, Paul Bo San Lai, Jose Luis Beristain-Hernandez, Álvarez Juan, Haralds Plaudis, Dionisios Vrochides, Vincenzo Neri, Vimalraj Velayutham, Aleksey Andrianov, Joan Figueras, Kjetil Soreide, Aliaksei Shcherba, Mahir Gachabayov, Roger G. Keith, Georgios Tsoulfas, Michael Anthony Fink, Stefano Crippa, Mehrdad Nikfarjam, Dibyajyoti Bora, Rajendra Desai, Marcello Donati, Jan Jin Bong, Emma Martínez Moneo, Gareth Morris-Stiff, Ahmet Coker, Alexandre Prado de Resende, Suryabhan Sakhahari Bhalerao, Sadiq S. Sikora, Dezső Kelemen, László Czakó, Hariharan Ramesh, Oleg Rummo, Aliaksei Fedaruk, Aliaksei Shcherba, Alexey Hlinnik, Madhusudhan Chinthakindi, Traian Dumitrascu, Vyacheslav Egorov, Vincent Bettschart, Michele Molinari, E. Aldana D. Guillermo, Susan L. Orloff, Daniel Vasilev Kostov, Laurent Sulpice, Brett Knowles, Yasutoshi Kimura, Gabriele Marangoni, Rajeev Joshi, Tibor Gyökeres, Bedin, V. Vladimir, Arpad Ivanecz, Adelmo Antonucci, Jones A.O. Omoshoro-Jones, Richard Nakache, Marco Del Chiaro, Marianne Johnstone, Tomoaki Saito, Gianpaolo Balzano, Vyacheslav Egorov, Serge Chooklin, Piero Boraschi, Walter Park, Pedro Nuno Valente Reis Pereira, Nico Pagano, Pavlos Lykoudis, Lars Ivo Partecke, Aliaksandr Siatkouski, Rosa Jorba Martín, Yasunari Kawabata, Luís Carvalho Lourenço, Carlos Marra-Lopez, Jun Kyu Lee, Nils Habbe, Robert C. Verdonk, Yliya Rabotyagova, Rupjyoti Talukdar, Luca Frulloni, Shamil Galeev, Zoltán Berger, Takeo Yasuda, Thilo Hackert, Ziyovuddin Saatov, Dimitri Aristotle Raptis, Jaume Boadas, Francesco Vitali, Livia Archibugi, Miroslav Ryska, Balazs Tihanyi, Vikesh K. Singh, Atsushi Masamune, Paul Yeaton, Kerrington D. Smith, Shrey Modi, Laura Cosen-Binker, Savio George Barreto, Eugenio Morandi, Sergio Valeri, Cintia Yoko Morioka, Luis F. Lara, Yoshifumi Takeyama, Frank G. Gress, Young Dong Yu, Ezio Gaia, Sorin Traian Barbu, Ali Tüzün İnce, Akkraporn Deeprasertvit, Yu Ting Chang, Stephen Olusola Abiola, Sabite Kacar, Peter Muscarella, Henri Braat, Samuel Han, Ali A. Aghdassi, Jean Louis Frossard, Jill P. Smith, M. P. Schwartz, H. M. van Dullemen, N. G. Venneman, B. W.M. Spanier, Sjoerd Kuiken, Erwin van Geenen, Greg Beilman, Georgios Papachristou, Oscar Chapa Azuela, P. van der Schaar, Nevin Oruc, Marie Paule Anten, William H. Nealon, Jesús García-Cano, Manol Jovani, Ziad Melki, Mustafa Mohammed Ahmed Ibrahim, M. U. Awajdarip, Mohammad Azam, K. G. Sabu, Igor Ermolaev, Shiran Shetty, Belei Oana, Juris Pokrotnieks, Malgorzata Lazuchiewicz-Kot, Riadh Bouali, Marek Winiarski, Marcus Schmitt, Mihai Rimbas, Alexander Meining, Bories Erwan, Peter N. Meier, Rainer Schoefl, Ahmed Youssef Altonbary, Igor Marsteller, Ingo Wallstabe, Skerdi Prifti, Arnaud Lemmers, M. Horvath, Ajay Kumar, Joseph J. Palermo

Surgery

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

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	https://doi.org/10.1016/j.hpb.2017.07.006
State	Published - Nov 2017

ASJC Scopus subject areas

Hepatology
Gastroenterology

Access to Document

10.1016/j.hpb.2017.07.006

Cite this

Issa, Y., van Santvoort, H. C., Fockens, P., Besselink, M. G., Bollen, T. L., Bruno, M. J., Boermeester, M. A., Moody, F. G., Bertrand, C., Johnson, C., van Lander, A., Carter, R., Conneely, J. B., Berrevoet, F., Sousa Silva, D., Li, Z. F., Lévy, P., Oppong, K., Gardner, T. B., ... Palermo, J. J. (2017). Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study. HPB, 19(11), 978-985. https://doi.org/10.1016/j.hpb.2017.07.006

Issa, Y, van Santvoort, HC, Fockens, P, Besselink, MG, Bollen, TL, Bruno, MJ, Boermeester, MA, Moody, FG, Bertrand, C, Johnson, C, van Lander, A, Carter, R, Conneely, JB, Berrevoet, F, Sousa Silva, D, Li, ZF, Lévy, P, Oppong, K, Gardner, TB, Wilcox, CM, French, J, Steer, M, Bradley, EL, Layer, P, Napoleon, B, Mosquera, JA, Gouma, DJ, Andersson, R, Manzelli, A, Klaase, JM, Falconi, M, de-Madaria, E, Casadei, R, Malleo, G, Pezzilli, R, Malecka-Panas, E, Lohr, M, Mayerle, J, Rauws, EAJ, Freeman, ML, Ariffin, AC, Vasavada, B, Lai, PBS, Beristain-Hernandez, JL, Juan, Á, Plaudis, H, Vrochides, D, Neri, V, Velayutham, V, Andrianov, A, Figueras, J, Soreide, K, Shcherba, A, Gachabayov, M, Keith, RG, Tsoulfas, G, Fink, MA, Crippa, S, Nikfarjam, M, Bora, D, Desai, R, Donati, M, Bong, JJ, Martínez Moneo, E, Morris-Stiff, G, Coker, A, de Resende, AP, Bhalerao, SS, Sikora, SS, Kelemen, D, Czakó, L, Ramesh, H, Rummo, O, Fedaruk, A, Shcherba, A, Hlinnik, A, Chinthakindi, M, Dumitrascu, T, Egorov, V, Bettschart, V, Molinari, M, Guillermo, EAD, Orloff, SL, Kostov, DV, Sulpice, L, Knowles, B, Kimura, Y, Marangoni, G, Joshi, R, Gyökeres, T, Bedin, Vladimir, V, Ivanecz, A, Antonucci, A, Omoshoro-Jones, JAO, Nakache, R, Del Chiaro, M, Johnstone, M, Saito, T, Balzano, G, Egorov, V, Chooklin, S, Boraschi, P, Park, W, Pereira, PNVR, Pagano, N, Lykoudis, P, Partecke, LI, Siatkouski, A, Martín, RJ, Kawabata, Y, Lourenço, LC, Marra-Lopez, C, Lee, JK, Habbe, N, Verdonk, RC, Rabotyagova, Y, Talukdar, R, Frulloni, L, Galeev, S, Berger, Z, Yasuda, T, Hackert, T, Saatov, Z, Raptis, DA, Boadas, J, Vitali, F, Archibugi, L, Ryska, M, Tihanyi, B, Singh, VK, Masamune, A, Yeaton, P, Smith, KD, Modi, S, Cosen-Binker, L, Barreto, SG, Morandi, E, Valeri, S, Morioka, CY, Lara, LF, Takeyama, Y, Gress, FG, Yu, YD, Gaia, E, Barbu, ST, İnce, AT, Deeprasertvit, A, Chang, YT, Abiola, SO, Kacar, S, Muscarella, P, Braat, H, Han, S, Aghdassi, AA, Frossard, JL, Smith, JP, Schwartz, MP, van Dullemen, HM, Venneman, NG, Spanier, BWM, Kuiken, S, van Geenen, E, Beilman, G, Papachristou, G, Chapa Azuela, O, van der Schaar, P, Oruc, N, Anten, MP, Nealon, WH, García-Cano, J, Jovani, M, Melki, Z, Ibrahim, MMA, Awajdarip, MU, Azam, M, Sabu, KG, Ermolaev, I, Shetty, S, Oana, B, Pokrotnieks, J, Lazuchiewicz-Kot, M, Bouali, R, Winiarski, M, Schmitt, M, Rimbas, M, Meining, A, Erwan, B, Meier, PN, Schoefl, R, Altonbary, AY, Marsteller, I, Wallstabe, I, Prifti, S, Lemmers, A, Horvath, M, Kumar, A & Palermo, JJ 2017, 'Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study', HPB, vol. 19, no. 11, pp. 978-985. https://doi.org/10.1016/j.hpb.2017.07.006

@article{ec2e4f6caa7c42dfa6dc724d37ba7886,

title = "Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study",

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 B{\"u}chler (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.",

author = "Yama Issa and {van Santvoort}, {Hjalmar C.} and Paul Fockens and Besselink, {Marc G.} and Bollen, {Thomas L.} and Bruno, {Marco J.} and Boermeester, {Marja A.} and Moody, {Frank G.} and Claude Bertrand and Colin Johnson and {van Lander}, Aude and Ross Carter and Conneely, {John B.} and Frederik Berrevoet and {Sousa Silva}, Donz{\'i}lia and Li, {Zong Fang} and Philippe L{\'e}vy and Kofi Oppong and Gardner, {Timothy B.} and Wilcox, {C. Mel} and Jeremy French and Michael Steer and Bradley, {Edward L.} and Peter Layer and Bertrand Napoleon and Mosquera, {Jorge Antonio} and Gouma, {D. J.} and Roland Andersson and Antonio Manzelli and Klaase, {J. M.} and Massimo Falconi and Enrique de-Madaria and Riccardo Casadei and Giuseppe Malleo and Raffaele Pezzilli and Ewa Malecka-Panas and Matthias Lohr and Julia Mayerle and Rauws, {Erik A.J.} and Freeman, {Martin L.} and Ariffin, {Affirul Chairil} and Bhavin Vasavada and Lai, {Paul Bo San} and Beristain-Hernandez, {Jose Luis} and {\'A}lvarez Juan and Haralds Plaudis and Dionisios Vrochides and Vincenzo Neri and Vimalraj Velayutham and Aleksey Andrianov and Joan Figueras and Kjetil Soreide and Aliaksei Shcherba and Mahir Gachabayov and Keith, {Roger G.} and Georgios Tsoulfas and Fink, {Michael Anthony} and Stefano Crippa and Mehrdad Nikfarjam and Dibyajyoti Bora and Rajendra Desai and Marcello Donati and Bong, {Jan Jin} and {Mart{\'i}nez Moneo}, Emma and Gareth Morris-Stiff and Ahmet Coker and {de Resende}, {Alexandre Prado} and Bhalerao, {Suryabhan Sakhahari} and Sikora, {Sadiq S.} and Dezs{\H o} Kelemen and L{\'a}szl{\'o} Czak{\'o} and Hariharan Ramesh and Oleg Rummo and Aliaksei Fedaruk and Aliaksei Shcherba and Alexey Hlinnik and Madhusudhan Chinthakindi and Traian Dumitrascu and Vyacheslav Egorov and Vincent Bettschart and Michele Molinari and Guillermo, {E. Aldana D.} and Orloff, {Susan L.} and Kostov, {Daniel Vasilev} and Laurent Sulpice and Brett Knowles and Yasutoshi Kimura and Gabriele Marangoni and Rajeev Joshi and Tibor Gy{\"o}keres and Bedin and V. Vladimir and Arpad Ivanecz and Adelmo Antonucci and Omoshoro-Jones, {Jones A.O.} and Richard Nakache and {Del Chiaro}, Marco and Marianne Johnstone and Tomoaki Saito and Gianpaolo Balzano and Vyacheslav Egorov and Serge Chooklin and Piero Boraschi and Walter Park and Pereira, {Pedro Nuno Valente Reis} and Nico Pagano and Pavlos Lykoudis and Partecke, {Lars Ivo} and Aliaksandr Siatkouski and Mart{\'i}n, {Rosa Jorba} and Yasunari Kawabata and Louren{\c c}o, {Lu{\'i}s Carvalho} and Carlos Marra-Lopez and Lee, {Jun Kyu} and Nils Habbe and Verdonk, {Robert C.} and Yliya Rabotyagova and Rupjyoti Talukdar and Luca Frulloni and Shamil Galeev and Zolt{\'a}n Berger and Takeo Yasuda and Thilo Hackert and Ziyovuddin Saatov and Raptis, {Dimitri Aristotle} and Jaume Boadas and Francesco Vitali and Livia Archibugi and Miroslav Ryska and Balazs Tihanyi and Singh, {Vikesh K.} and Atsushi Masamune and Paul Yeaton and Smith, {Kerrington D.} and Shrey Modi and Laura Cosen-Binker and Barreto, {Savio George} and Eugenio Morandi and Sergio Valeri and Morioka, {Cintia Yoko} and Lara, {Luis F.} and Yoshifumi Takeyama and Gress, {Frank G.} and Yu, {Young Dong} and Ezio Gaia and Barbu, {Sorin Traian} and İnce, {Ali T{\"u}z{\"u}n} and Akkraporn Deeprasertvit and Chang, {Yu Ting} and Abiola, {Stephen Olusola} and Sabite Kacar and Peter Muscarella and Henri Braat and Samuel Han and Aghdassi, {Ali A.} and Frossard, {Jean Louis} and Smith, {Jill P.} and Schwartz, {M. P.} and {van Dullemen}, {H. M.} and Venneman, {N. G.} and Spanier, {B. W.M.} and Sjoerd Kuiken and {van Geenen}, Erwin and Greg Beilman and Georgios Papachristou and {Chapa Azuela}, Oscar and {van der Schaar}, P. and Nevin Oruc and Anten, {Marie Paule} and Nealon, {William H.} and Jes{\'u}s Garc{\'i}a-Cano and Manol Jovani and Ziad Melki and Ibrahim, {Mustafa Mohammed Ahmed} and Awajdarip, {M. U.} and Mohammad Azam and Sabu, {K. G.} and Igor Ermolaev and Shiran Shetty and Belei Oana and Juris Pokrotnieks and Malgorzata Lazuchiewicz-Kot and Riadh Bouali and Marek Winiarski and Marcus Schmitt and Mihai Rimbas and Alexander Meining and Bories Erwan and Meier, {Peter N.} and Rainer Schoefl and Altonbary, {Ahmed Youssef} and Igor Marsteller and Ingo Wallstabe and Skerdi Prifti and Arnaud Lemmers and M. Horvath and Ajay Kumar and Palermo, {Joseph J.}",

note = "Publisher Copyright: {\textcopyright} 2017 International Hepato-Pancreato-Biliary Association Inc.",

year = "2017",

month = nov,

doi = "10.1016/j.hpb.2017.07.006",

language = "English (US)",

volume = "19",

pages = "978--985",

journal = "HPB",

issn = "1365-182X",

publisher = "John Wiley and Sons Inc.",

number = "11",

}

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 L.

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

Y1 - 2017/11

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

C2 - 28821411

AN - SCOPUS:85027404919

VL - 19

SP - 978

EP - 985

JO - HPB

JF - HPB

SN - 1365-182X

IS - 11

ER -

Diagnosis and treatment in chronic pancreatitis: an international survey and case vignette study

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