Diagnosis and treatment of pancreatic duct disruption or disconnection: an international expert survey and case vignette study
Pancreatic duct disruption or disconnection is a potentially severe complication of necrotizing pancreatitis. With no existing treatment guidelines, it is unclear whether there is any consensus among experts in clinical practice. We evaluated current expert opinion regarding the diagnosis and treatm...
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| Veröffentlicht in: | HPB (Oxford, England) England), 2021-08, Vol.23 (8), p.1201-1208 |
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| creator | Boxhoorn, Lotte Timmerhuis, Hester C. Verdonk, Robert C. Besselink, Marc G. Bollen, Thomas L. Bruno, Marco J. Elmunzer, B. Joseph Fockens, Paul Horvath, Karen D. van Santvoort, Hjalmar C. Voermans, Rogier P. Albert, J. Arvanitakis, M. Badaoui, A. Barthet, M. van Biervliet, G. Bradley, E. Boermeester, M. Buchler, M. Cappendijk, V. Charnley, R. Connor, S. Dejong, C. Dellinger, P. Dervenis, C. Deviere, J. Dumonceau, J. van Eijck, C. Fagenholz, P. Castillo, C.Fernandez-del Forsmark, C. Freeman, M. French, J. van Goor, H. Haveman, J.W. van Hooft, J. Hucl, T. Isaji, S. Jagielski, M. Karjula, H. Lerch, M. Lévy, P. Lillemoe, K. Löhr, M. Mayerle, J. Mittal, A. Morgan, D. Moon, S. Nieuwenhuijs, V. Sarr, M. Seewald, S. Sherman, S. Singh, V. Siriwardena, A. Stommel, M. Tann, M. Téllez-Avina, F. Timmer, R. Traverso, W. Radenkovic, D. Rana, S. Rebours, V. Pelaez-Luna, M. Poley, J.W. Windsor, J. Zaheer, A. Zyromski, N. |
| description | Pancreatic duct disruption or disconnection is a potentially severe complication of necrotizing pancreatitis. With no existing treatment guidelines, it is unclear whether there is any consensus among experts in clinical practice. We evaluated current expert opinion regarding the diagnosis and treatment of pancreatic duct disruption and disconnection in an international case vignette study.
An online case vignette survey was sent to 110 international expert pancreatologists. Expert selection was based on publications in the last 5 years and/or participation in development of IAP/APA and ESGE guidelines on acute pancreatitis. Consensus was defined as agreement by at least 75% of the experts.
The response rate was 51% (n = 56). Forty-four experts (79%) obtained a MRI/MRCP and 52 experts (93%) measured amylase levels in percutaneous drain fluid to evaluate pancreatic duct integrity. The majority of experts favored endoscopic transluminal drainage for infected (peri)pancreatic necrosis and pancreatic duct disruption (84%, n = 45) or disconnection (88%, n = 43). Consensus was lacking regarding the treatment of patients with persistent percutaneous drain production, and with persistent sterile necrosis.
This international survey of experts demonstrates that there are many areas for which no consensus existed, providing clear focus for future investigation. |
| doi_str_mv | 10.1016/j.hpb.2020.11.1148 |
| format | Article |
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An online case vignette survey was sent to 110 international expert pancreatologists. Expert selection was based on publications in the last 5 years and/or participation in development of IAP/APA and ESGE guidelines on acute pancreatitis. Consensus was defined as agreement by at least 75% of the experts.
The response rate was 51% (n = 56). Forty-four experts (79%) obtained a MRI/MRCP and 52 experts (93%) measured amylase levels in percutaneous drain fluid to evaluate pancreatic duct integrity. The majority of experts favored endoscopic transluminal drainage for infected (peri)pancreatic necrosis and pancreatic duct disruption (84%, n = 45) or disconnection (88%, n = 43). Consensus was lacking regarding the treatment of patients with persistent percutaneous drain production, and with persistent sterile necrosis.
This international survey of experts demonstrates that there are many areas for which no consensus existed, providing clear focus for future investigation.</description><identifier>ISSN: 1365-182X</identifier><identifier>EISSN: 1477-2574</identifier><identifier>DOI: 10.1016/j.hpb.2020.11.1148</identifier><identifier>PMID: 33541807</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acute Disease ; Drainage ; Humans ; Pancreatic Ducts - diagnostic imaging ; Pancreatic Ducts - surgery ; Pancreatitis, Acute Necrotizing - diagnostic imaging ; Pancreatitis, Acute Necrotizing - surgery</subject><ispartof>HPB (Oxford, England), 2021-08, Vol.23 (8), p.1201-1208</ispartof><rights>2020 The Authors</rights><rights>Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-85f39e58e7b8f717af1fc7281cef527d963801d57bebe9f75b729fd4e4897f7b3</citedby><cites>FETCH-LOGICAL-c400t-85f39e58e7b8f717af1fc7281cef527d963801d57bebe9f75b729fd4e4897f7b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33541807$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boxhoorn, Lotte</creatorcontrib><creatorcontrib>Timmerhuis, Hester C.</creatorcontrib><creatorcontrib>Verdonk, Robert C.</creatorcontrib><creatorcontrib>Besselink, Marc G.</creatorcontrib><creatorcontrib>Bollen, Thomas L.</creatorcontrib><creatorcontrib>Bruno, Marco J.</creatorcontrib><creatorcontrib>Elmunzer, B. 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With no existing treatment guidelines, it is unclear whether there is any consensus among experts in clinical practice. We evaluated current expert opinion regarding the diagnosis and treatment of pancreatic duct disruption and disconnection in an international case vignette study.
An online case vignette survey was sent to 110 international expert pancreatologists. Expert selection was based on publications in the last 5 years and/or participation in development of IAP/APA and ESGE guidelines on acute pancreatitis. Consensus was defined as agreement by at least 75% of the experts.
The response rate was 51% (n = 56). Forty-four experts (79%) obtained a MRI/MRCP and 52 experts (93%) measured amylase levels in percutaneous drain fluid to evaluate pancreatic duct integrity. The majority of experts favored endoscopic transluminal drainage for infected (peri)pancreatic necrosis and pancreatic duct disruption (84%, n = 45) or disconnection (88%, n = 43). Consensus was lacking regarding the treatment of patients with persistent percutaneous drain production, and with persistent sterile necrosis.
This international survey of experts demonstrates that there are many areas for which no consensus existed, providing clear focus for future investigation.</description><subject>Acute Disease</subject><subject>Drainage</subject><subject>Humans</subject><subject>Pancreatic Ducts - diagnostic imaging</subject><subject>Pancreatic Ducts - surgery</subject><subject>Pancreatitis, Acute Necrotizing - diagnostic imaging</subject><subject>Pancreatitis, Acute Necrotizing - surgery</subject><issn>1365-182X</issn><issn>1477-2574</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM1uGyEUhVHVKE7dvEAWEctuxgVmxjBRN1X6FylSNonUHWLg4mDZMAHGijd59jC102UkpMu5OucIPoQuKFlQQpdf14vHoV8wwoqm5TTiAzqjDecVa3nzsdzrZVtRwf7O0KeU1oSwkutO0ayu24YKws_Qyw-nVj4kl7DyBucIKm_BZxwsHpTXk3Yam1FnbFyK45Bd8DjESengPehpcVXS2PkM0atJqw2G5wFixmmMO9j_K9cqAd65lYecAac8mv1ndGLVJsH5cc7Rw6-f99d_qtu73zfX328r3RCSK9HauoNWAO-F5ZQrS63mTFANtmXcdMtaEGpa3kMPneVtz1lnTQON6LjlfT1HXw69QwxPI6Qst-X5sNkoD2FMkjWC02VB2RUrO1h1DClFsHKIbqviXlIiJ-5yLQt3OXGXlMqJewldHvvHfgvmf-QNdDF8Oxig_HLnIMqkHXgNxsWCUJrg3ut_BYw7lsQ</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Boxhoorn, Lotte</creator><creator>Timmerhuis, Hester C.</creator><creator>Verdonk, Robert C.</creator><creator>Besselink, Marc G.</creator><creator>Bollen, Thomas L.</creator><creator>Bruno, Marco J.</creator><creator>Elmunzer, B. 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Joseph ; Fockens, Paul ; Horvath, Karen D. ; van Santvoort, Hjalmar C. ; Voermans, Rogier P. ; Albert, J. ; Arvanitakis, M. ; Badaoui, A. ; Barthet, M. ; van Biervliet, G. ; Bradley, E. ; Boermeester, M. ; Buchler, M. ; Cappendijk, V. ; Charnley, R. ; Connor, S. ; Dejong, C. ; Dellinger, P. ; Dervenis, C. ; Deviere, J. ; Dumonceau, J. ; van Eijck, C. ; Fagenholz, P. ; Castillo, C.Fernandez-del ; Forsmark, C. ; Freeman, M. ; French, J. ; van Goor, H. ; Haveman, J.W. ; van Hooft, J. ; Hucl, T. ; Isaji, S. ; Jagielski, M. ; Karjula, H. ; Lerch, M. ; Lévy, P. ; Lillemoe, K. ; Löhr, M. ; Mayerle, J. ; Mittal, A. ; Morgan, D. ; Moon, S. ; Nieuwenhuijs, V. ; Sarr, M. ; Seewald, S. ; Sherman, S. ; Singh, V. ; Siriwardena, A. ; Stommel, M. ; Tann, M. ; Téllez-Avina, F. ; Timmer, R. ; Traverso, W. ; Radenkovic, D. ; Rana, S. ; Rebours, V. ; Pelaez-Luna, M. ; Poley, J.W. ; Windsor, J. ; Zaheer, A. ; Zyromski, N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-85f39e58e7b8f717af1fc7281cef527d963801d57bebe9f75b729fd4e4897f7b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute Disease</topic><topic>Drainage</topic><topic>Humans</topic><topic>Pancreatic Ducts - diagnostic imaging</topic><topic>Pancreatic Ducts - surgery</topic><topic>Pancreatitis, Acute Necrotizing - diagnostic imaging</topic><topic>Pancreatitis, Acute Necrotizing - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boxhoorn, Lotte</creatorcontrib><creatorcontrib>Timmerhuis, Hester C.</creatorcontrib><creatorcontrib>Verdonk, Robert C.</creatorcontrib><creatorcontrib>Besselink, Marc G.</creatorcontrib><creatorcontrib>Bollen, Thomas L.</creatorcontrib><creatorcontrib>Bruno, Marco J.</creatorcontrib><creatorcontrib>Elmunzer, B. Joseph</creatorcontrib><creatorcontrib>Fockens, Paul</creatorcontrib><creatorcontrib>Horvath, Karen D.</creatorcontrib><creatorcontrib>van Santvoort, Hjalmar C.</creatorcontrib><creatorcontrib>Voermans, Rogier P.</creatorcontrib><creatorcontrib>Albert, J.</creatorcontrib><creatorcontrib>Arvanitakis, M.</creatorcontrib><creatorcontrib>Badaoui, A.</creatorcontrib><creatorcontrib>Barthet, M.</creatorcontrib><creatorcontrib>van Biervliet, G.</creatorcontrib><creatorcontrib>Bradley, E.</creatorcontrib><creatorcontrib>Boermeester, M.</creatorcontrib><creatorcontrib>Buchler, M.</creatorcontrib><creatorcontrib>Cappendijk, V.</creatorcontrib><creatorcontrib>Charnley, R.</creatorcontrib><creatorcontrib>Connor, S.</creatorcontrib><creatorcontrib>Dejong, C.</creatorcontrib><creatorcontrib>Dellinger, P.</creatorcontrib><creatorcontrib>Dervenis, C.</creatorcontrib><creatorcontrib>Deviere, J.</creatorcontrib><creatorcontrib>Dumonceau, J.</creatorcontrib><creatorcontrib>van Eijck, C.</creatorcontrib><creatorcontrib>Fagenholz, P.</creatorcontrib><creatorcontrib>Castillo, C.Fernandez-del</creatorcontrib><creatorcontrib>Forsmark, C.</creatorcontrib><creatorcontrib>Freeman, M.</creatorcontrib><creatorcontrib>French, J.</creatorcontrib><creatorcontrib>van Goor, H.</creatorcontrib><creatorcontrib>Haveman, J.W.</creatorcontrib><creatorcontrib>van Hooft, J.</creatorcontrib><creatorcontrib>Hucl, T.</creatorcontrib><creatorcontrib>Isaji, S.</creatorcontrib><creatorcontrib>Jagielski, M.</creatorcontrib><creatorcontrib>Karjula, H.</creatorcontrib><creatorcontrib>Lerch, M.</creatorcontrib><creatorcontrib>Lévy, P.</creatorcontrib><creatorcontrib>Lillemoe, K.</creatorcontrib><creatorcontrib>Löhr, M.</creatorcontrib><creatorcontrib>Mayerle, J.</creatorcontrib><creatorcontrib>Mittal, A.</creatorcontrib><creatorcontrib>Morgan, D.</creatorcontrib><creatorcontrib>Moon, S.</creatorcontrib><creatorcontrib>Nieuwenhuijs, V.</creatorcontrib><creatorcontrib>Sarr, M.</creatorcontrib><creatorcontrib>Seewald, S.</creatorcontrib><creatorcontrib>Sherman, S.</creatorcontrib><creatorcontrib>Singh, V.</creatorcontrib><creatorcontrib>Siriwardena, A.</creatorcontrib><creatorcontrib>Stommel, M.</creatorcontrib><creatorcontrib>Tann, M.</creatorcontrib><creatorcontrib>Téllez-Avina, F.</creatorcontrib><creatorcontrib>Timmer, R.</creatorcontrib><creatorcontrib>Traverso, W.</creatorcontrib><creatorcontrib>Radenkovic, D.</creatorcontrib><creatorcontrib>Rana, S.</creatorcontrib><creatorcontrib>Rebours, V.</creatorcontrib><creatorcontrib>Pelaez-Luna, M.</creatorcontrib><creatorcontrib>Poley, J.W.</creatorcontrib><creatorcontrib>Windsor, J.</creatorcontrib><creatorcontrib>Zaheer, A.</creatorcontrib><creatorcontrib>Zyromski, N.</creatorcontrib><creatorcontrib>for the Dutch Pancreatitis Study Group</creatorcontrib><creatorcontrib>Dutch Pancreatitis Study Group</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>HPB (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Boxhoorn, Lotte</au><au>Timmerhuis, Hester C.</au><au>Verdonk, Robert C.</au><au>Besselink, Marc G.</au><au>Bollen, Thomas L.</au><au>Bruno, Marco J.</au><au>Elmunzer, B. Joseph</au><au>Fockens, Paul</au><au>Horvath, Karen D.</au><au>van Santvoort, Hjalmar C.</au><au>Voermans, Rogier P.</au><au>Albert, J.</au><au>Arvanitakis, M.</au><au>Badaoui, A.</au><au>Barthet, M.</au><au>van Biervliet, G.</au><au>Bradley, E.</au><au>Boermeester, M.</au><au>Buchler, M.</au><au>Cappendijk, V.</au><au>Charnley, R.</au><au>Connor, S.</au><au>Dejong, C.</au><au>Dellinger, P.</au><au>Dervenis, C.</au><au>Deviere, J.</au><au>Dumonceau, J.</au><au>van Eijck, C.</au><au>Fagenholz, P.</au><au>Castillo, C.Fernandez-del</au><au>Forsmark, C.</au><au>Freeman, M.</au><au>French, J.</au><au>van Goor, H.</au><au>Haveman, J.W.</au><au>van Hooft, J.</au><au>Hucl, T.</au><au>Isaji, S.</au><au>Jagielski, M.</au><au>Karjula, H.</au><au>Lerch, M.</au><au>Lévy, P.</au><au>Lillemoe, K.</au><au>Löhr, M.</au><au>Mayerle, J.</au><au>Mittal, A.</au><au>Morgan, D.</au><au>Moon, S.</au><au>Nieuwenhuijs, V.</au><au>Sarr, M.</au><au>Seewald, S.</au><au>Sherman, S.</au><au>Singh, V.</au><au>Siriwardena, A.</au><au>Stommel, M.</au><au>Tann, M.</au><au>Téllez-Avina, F.</au><au>Timmer, R.</au><au>Traverso, W.</au><au>Radenkovic, D.</au><au>Rana, S.</au><au>Rebours, V.</au><au>Pelaez-Luna, M.</au><au>Poley, J.W.</au><au>Windsor, J.</au><au>Zaheer, A.</au><au>Zyromski, N.</au><aucorp>for the Dutch Pancreatitis Study Group</aucorp><aucorp>Dutch Pancreatitis Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis and treatment of pancreatic duct disruption or disconnection: an international expert survey and case vignette study</atitle><jtitle>HPB (Oxford, England)</jtitle><addtitle>HPB (Oxford)</addtitle><date>2021-08</date><risdate>2021</risdate><volume>23</volume><issue>8</issue><spage>1201</spage><epage>1208</epage><pages>1201-1208</pages><issn>1365-182X</issn><eissn>1477-2574</eissn><abstract>Pancreatic duct disruption or disconnection is a potentially severe complication of necrotizing pancreatitis. With no existing treatment guidelines, it is unclear whether there is any consensus among experts in clinical practice. We evaluated current expert opinion regarding the diagnosis and treatment of pancreatic duct disruption and disconnection in an international case vignette study.
An online case vignette survey was sent to 110 international expert pancreatologists. Expert selection was based on publications in the last 5 years and/or participation in development of IAP/APA and ESGE guidelines on acute pancreatitis. Consensus was defined as agreement by at least 75% of the experts.
The response rate was 51% (n = 56). Forty-four experts (79%) obtained a MRI/MRCP and 52 experts (93%) measured amylase levels in percutaneous drain fluid to evaluate pancreatic duct integrity. The majority of experts favored endoscopic transluminal drainage for infected (peri)pancreatic necrosis and pancreatic duct disruption (84%, n = 45) or disconnection (88%, n = 43). Consensus was lacking regarding the treatment of patients with persistent percutaneous drain production, and with persistent sterile necrosis.
This international survey of experts demonstrates that there are many areas for which no consensus existed, providing clear focus for future investigation.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>33541807</pmid><doi>10.1016/j.hpb.2020.11.1148</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1365-182X |
| ispartof | HPB (Oxford, England), 2021-08, Vol.23 (8), p.1201-1208 |
| issn | 1365-182X 1477-2574 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2487162029 |
| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Acute Disease Drainage Humans Pancreatic Ducts - diagnostic imaging Pancreatic Ducts - surgery Pancreatitis, Acute Necrotizing - diagnostic imaging Pancreatitis, Acute Necrotizing - surgery |
| title | Diagnosis and treatment of pancreatic duct disruption or disconnection: an international expert survey and case vignette study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-19T17%3A50%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Diagnosis%20and%20treatment%20of%20pancreatic%20duct%20disruption%20or%20disconnection:%20an%20international%20expert%20survey%20and%20case%20vignette%20study&rft.jtitle=HPB%20(Oxford,%20England)&rft.au=Boxhoorn,%20Lotte&rft.aucorp=for%20the%20Dutch%20Pancreatitis%20Study%20Group&rft.date=2021-08&rft.volume=23&rft.issue=8&rft.spage=1201&rft.epage=1208&rft.pages=1201-1208&rft.issn=1365-182X&rft.eissn=1477-2574&rft_id=info:doi/10.1016/j.hpb.2020.11.1148&rft_dat=%3Cproquest_cross%3E2487162029%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2487162029&rft_id=info:pmid/33541807&rft_els_id=S1365182X20323935&rfr_iscdi=true |