Search

Your search keyword '"Paul Fockens"' showing total 313 results
Start Over Author "Paul Fockens" Publisher elsevier bv
313 results on '"Paul Fockens"'

1. Diagnostic accuracy of the AGA, IAP, and European guidelines for detecting advanced neoplasia in intraductal papillary mucinous neoplasm/neoplasia

Author

Nadine C.M. van Huijgevoort, Sanne A.M. Hoogenboom, Selma J. Lekkerkerker, Olivier R. Busch, Marco Del Chiaro, Paul Fockens, Inne Somers, Joanne Verheij, Rogier P. Voermans, Marc G. Besselink, Jeanin E. van Hooft, Pathology, CCA - Cancer biology and immunology, CCA - Imaging and biomarkers, Graduate School, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, and Surgery

Subjects
Hepatology, Endocrinology, Diabetes and Metabolism, Gastroenterology
Abstract

Background: Follow-up in patients with intraductal papillary mucinous neoplasm (IPMN) aims to detect advanced neoplasia (high-grade dysplasia/cancer) in an early stage. The 2015 American Gastroenterological Association (AGA), 2017 International Association of Pancreatology (IAP), and the 2018 European Study Group on Cystic tumours of the Pancreas (European) guidelines differ in their recommendations on indications for surgery. However, it remains unclear which guideline is most accurate in predicting advanced neoplasia in IPMN. Methods: Patients who underwent surgery were extracted from a prospective database (January 2006–January 2021). In patients with IPMN, final pathology was compared with the indication for surgery according to the guidelines. ROC-curves were calculated to determine the diagnostic accuracy for each guideline. Results: Overall, 247 patients underwent surgery for cystic lesions. In 145 patients with IPMN, 52 had advanced neoplasia, of which the AGA guideline would have advised surgery in 14 (27%), the IAP and European guideline in 49 (94%) and 50 (96%). In 93 patients without advanced neoplasia, the AGA, IAP, and European guidelines would incorrectly have advised surgery in 8 (8.6%), 77 (83%) and 71 (76%). Conclusion: The European and IAP guidelines are clearly superior in detecting advanced neoplasia in IPMN as compared to the AGA, albeit at the cost of a higher rate of unnecessary surgery. To harmonize care and to avoid confusion caused by conflicting statements, a global evidence-based guideline for PCN in collaboration with the various guidelines groups is required once the current guidelines require an update.

Published
2023

2. Peroral endoscopic myotomy versus pneumatic dilation in treatment-naive patients with achalasia: 5-year follow-up of a randomised controlled trial

Author

Thijs Kuipers, Fraukje A Ponds, Paul Fockens, Barbara A J Bastiaansen, Aaltje Lei, Renske A B Oude Nijhuis, Horst Neuhaus, Torsten Beyna, Jennis Kandler, Thomas Frieling, Philip W Y Chiu, Justin C Y Wu, Vivien W Y Wong, Guido Costamagna, Pietro Familiari, Peter J Kahrilas, John E Pandolfino, André J P M Smout, Albert J Bredenoord, Gastroenterology and hepatology, Gastroenterology and Hepatology, Graduate School, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Adult, Esophageal Achalasia, N/A, Hepatology, Settore MED/18 - CHIRURGIA GENERALE, Gastroenterology, Humans, Dilatation, Digestive System Surgical Procedures, Follow-Up Studies, Myotomy
Abstract

2-year follow-up data from our randomised controlled trial showed that peroral endoscopic myotomy is associated with a significantly higher efficacy than pneumatic dilation as initial treatment of therapy-naive patients with achalasia. Here we report therapeutic success rates in patients treated with peroral endoscopic myotomy compared with pneumatic dilation at the 5-year follow-up.We did a multicentre, randomised controlled trial in six hospitals in the Netherlands, Germany, Italy, Hong Kong, and the USA. Adults aged 18-80 years with newly diagnosed symptomatic achalasia (based on an Eckardt score3) were eligible for inclusion. Patients were randomly assigned (1:1) to peroral endoscopic myotomy or pneumatic dilation using web-based randomisation with a random block size of 8 and stratification according to site. Randomisation concealment for treatment type was double blind until official study enrolment. Treatment was unmasked because of the different technical approach of each procedure. Patients in the pneumatic dilation group were dilated with a single series of 30-35 mm balloons. The need for subsequent dilations in the pneumatic dilation group, and the need for dilation after initial treatment in the peroral endoscopic myotomy group, was considered treatment failure. The primary outcome was therapeutic success (Eckardt score ≤3 in the absence of severe treatment-related complications and no need for retreatment). Analysis of the primary outcome was by modified intention to treat, including all patients randomly assigned to a group, excluding those patients who did not receive treatment or were lost to follow-up. Safety was assessed in all included patients. This study is registered at the Dutch Trial Registry, NTR3593, and is completed.Between Sept 21, 2012, and July 20, 2015, 182 patients were assessed for eligibility, 133 of whom were included in the study and randomly assigned to peroral endoscopic myotomy (n=67) or pneumatic dilation (n=66). 5-year follow-up data were available for 62 patients in the peroral endoscopic myotomy group and 63 patients in the pneumatic dilation group. 50 (81%) patients in the peroral endoscopic myotomy group had treatment success at 5 years, compared with 25 (40%) in the pneumatic dilation group, an adjusted absolute difference of 41% (95% CI 25-57; p0·0001). Reasons for failure were no initial effect of treatment (one patient in the peroral endoscopic myotomy group vs 12 patients in the pneumatic dilation group) and recurrent symptoms causing treatment failure (11 patients in the peroral endoscopic myotomy group [seven patients between 2 and 5 years] vs 25 patients in the pneumatic dilation group [nine patients between 2 and 5 years]); one patient in the pneumatic dilation group had treatment failure due to an adverse event. Proton-pump inhibitor use (mostly daily) was significantly higher after peroral endoscopic myotomy than after pneumatic dilation among patients still in clinical remission (23 [46%] of 50 patients vs three [13%] of 24 patients; p=0·008). 5-year follow-up endoscopy of patients still in clinical remission showed reflux oesophagitis in 14 (33%) of 42 patients in the peroral endoscopic myotomy group (12 [29%] grade A or B, two [5%] grade C or D) and two (13%) of 16 patients in the pneumatic dilation group (two [13%] grade A or B, none grade C or D; p=0·19). No intervention-related serious adverse events occurred between 2 and 5 years after treatment. The following non-intervention-related serious adverse events occurred between 2 and 5 years: a stroke (one [2%]) in the peroral endoscopic myotomy group; and death due to a melanoma (one [2%]) and dementia (one [2%]) in the pneumatic dilation group.Based on this study, peroral endoscopic myotomy should be proposed as an initial treatment option for patients with achalasia. Although our study has shown that peroral endoscopic myotomy has greater long-term efficacy with a low risk of major treatment-related complications, this should not lead to abandonment of pneumatic dilation from clinical practice. Ideally, all treatment options should be discussed with treatment-naive patients with achalasia and a shared decision should be made.Fonds NutsOhra and European Society of Gastrointestinal Endoscopy.

Published
2022

3. Pancreas-preserving total duodenectomy for advanced duodenal polyposis in patients with familial adenomatous polyposis: short and long-term outcomes

Author

Arthur S. Aelvoet, Barbara A.J. Bastiaansen, Paul Fockens, Marc G. Besselink, Olivier R. Busch, Evelien Dekker, Gastroenterology and Hepatology, Graduate School, CCA - Cancer Treatment and Quality of Life, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and Surgery

Subjects
Adenoma, Postoperative Complications, Pancreatitis, Adenomatous Polyposis Coli, Hepatology, Duodenal Neoplasms, Acute Disease, Anastomosis, Surgical, Gastroenterology, Humans, Pancreas, Retrospective Studies
Abstract

Background: In patients with familial adenomatous polyposis (FAP), extensive nonmalignant duodenal polyposis not amenable to endoscopic management demands surgical resection for which pancreas-preserving total duodenectomy (PPTD) offers a pancreatic parenchyma sparing approach. Methods: This is a retrospective cohort study including consecutive patients who underwent PPTD for FAP. Reconstruction involved a Billroth II anastomosis with a short isolated jejunal limb to facilitate future endoscopic surveillance. Short and long-term outcomes were evaluated. Results: Overall, 30 patients underwent PPTD for Spigelman stage III (n = 6) or IV (n = 24). Sixteen patients experienced a severe complication (Clavien–Dindo grade III/IV) including postoperative pancreatic fistula (ISGPS grade B/C) in twelve. There was no all cause in-hospital and 90-day mortality. During follow-up (median 125 months), five patients developed acute pancreatitis, one new-onset diabetes and one exocrine pancreatic insufficiency. During endoscopic surveillance in 27 patients, jejunal adenomas were detected in 22 and advanced adenomas in 11. An additional surgical resection was required in four patients with extensive jejunal polyposis. None developed jejunal cancer. The 10-year overall survival rate was 93.3%. Conclusion: Postoperative morbidity after PPTD is substantial but on the long-term, rates of pancreatic insufficiencies are low. Most patients develop jejunal adenomas at follow-up, highlighting the need for endoscopic surveillance.

Published
2022

4. Diagnosis and treatment of pancreatic duct disruption or disconnection: an international expert survey and case vignette study

Author

S. Rana, M. Barthet, C. Fernandez-del Castillo, J. French, Karen D. Horvath, J. E. van Hooft, Christos Dervenis, M. Pelaez-Luna, H. van Goor, M.W. Büchler, Matthias Löhr, S. Connor, K. Lillemoe, V. Nieuwenhuijs, John A. Windsor, E. Bradley, W. Traverso, C.H.J. van Eijck, Shuiji Isaji, C. Dejong, Ajith K. Siriwardena, Martin L. Freeman, M. Jagielski, S. Moon, Richard Charnley, R. Timmer, Marianna Arvanitakis, Marja A. Boermeester, Rogier P. Voermans, H. Karjula, Chris E. Forsmark, Julia Mayerle, P. Fagenholz, Vijay P. Singh, Jacques Devière, A. Badaoui, A. Mittal, Vincent C. Cappendijk, Paul Fockens, Marc G. Besselink, Hjalmar C. van Santvoort, P. Dellinger, Stuart Sherman, N. Zyromski, M. Stommel, Jörg G. Albert, Jean-Marc Dumonceau, D. Morgan, F. Téllez-Avina, Hester C. Timmerhuis, Thomas L. Bollen, Vinciane Rebours, M. Tann, J.W. Poley, S. Seewald, Phillippe Levy, T. Hucl, B. Joseph Elmunzer, D. Radenkovic, Marco J. Bruno, J.W. Haveman, Lotte Boxhoorn, Robert C. Verdonk, A. Zaheer, Markus M. Lerch, Michael G. Sarr, G. van Biervliet, Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, Surgery, APH - Methodology, and Gastroenterology & Hepatology

Subjects
medicine.medical_specialty, Percutaneous, education, Amylase levels, MEDLINE, Case vignette, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Pancreatic duct, Response rate (survey), Hepatology, Pancreatitis, Acute Necrotizing, business.industry, General surgery, Pancreatic Ducts, Gastroenterology, medicine.disease, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Acute Disease, Drainage, Acute pancreatitis, 030211 gastroenterology & hepatology, Disconnection, business
Abstract

Contains fulltext : 238998.pdf (Publisher’s version ) (Open Access) BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: This international survey of experts demonstrates that there are many areas for which no consensus existed, providing clear focus for future investigation.

Published
2021

5. Urgent endoscopic retrograde cholangiopancreatography with sphincterotomy versus conservative treatment in predicted severe acute gallstone pancreatitis (APEC): a multicentre randomised controlled trial

Author

Olaf J. Bakker, Niels G. Venneman, Ben J.M. Witteman, Marie-Paule Anten, B W Marcel Spanier, Hendrik M. van Dullemen, Nora D L Hallensleben, Matthijs P. Schwartz, Erik J. Schoon, Rutger Quispel, René W M van der Hulst, Hjalmar C. van Santvoort, David W da Costa, Adriaan C.I.T.L. Tan, Janneke van Grinsven, Tessa E H Römkens, Rogier de Ridder, Wim van de Vrie, Sjoerd D. Kuiken, Carola H.M. Ruigrok, Robbert A. Hollemans, Robert C. Verdonk, Marc G. Besselink, Xavier J N M Smeets, Frank P. Vleggaar, Marco J. Bruno, Frank J G M Kubben, Robert J.F. Laheij, Casper H.J. van Eijck, Thomas L. Bollen, Jeroen M. Jansen, Jeanin E. van Hooft, Nicole S. Erler, Robin Timmer, Foke van Delft, Marno C.M. Rijk, Marcel G. W. Dijkgraaf, Paul Fockens, Sven M. van Dijk, Erwin J M van Geenen, Nicolien J. Schepers, Willem J. Thijs, G. Willemien Erkelens, Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Epidemiology and Data Science, APH - Methodology, Gastroenterology and Hepatology, Interne Geneeskunde, MUMC+: MA Maag Darm Lever (9), RS: FHML non-thematic output, Gastroenterology & Hepatology, Epidemiology, and Center for Liver, Digestive and Metabolic Diseases (CLDM)

Subjects
Male, medicine.medical_specialty, PATHOGENESIS, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], Gallstones, 030204 cardiovascular system & hematology, Conservative Treatment, DISEASE, law.invention, Sphincterotomy, Endoscopic, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, ACUTE NECROTIZING PANCREATITIS, 0302 clinical medicine, Randomized controlled trial, Cholestasis, law, EARLY DUCTAL DECOMPRESSION, MANAGEMENT, medicine, Clinical endpoint, Humans, EPIDEMIOLOGY, 030212 general & internal medicine, Aged, ACUTE CHOLANGITIS, Cholangiopancreatography, Endoscopic Retrograde, ACUTE BILIARY PANCREATITIS, Endoscopic retrograde cholangiopancreatography, Intention-to-treat analysis, medicine.diagnostic_test, business.industry, General Medicine, medicine.disease, Combined Modality Therapy, Surgery, Clinical trial, Treatment Outcome, Pancreatitis, Relative risk, Acute Disease, Female, OBSTRUCTION, business, CLINICAL-TRIALS
Abstract

BACKGROUND: It remains unclear whether urgent endoscopic retrograde cholangiopancreatography (ERCP) with biliary sphincterotomy improves the outcome of patients with gallstone pancreatitis without concomitant cholangitis. We did a randomised trial to compare urgent ERCP with sphincterotomy versus conservative treatment in patients with predicted severe acute gallstone pancreatitis.METHODS: In this multicentre, parallel-group, assessor-masked, randomised controlled superiority trial, patients with predicted severe (Acute Physiology and Chronic Health Evaluation II score ≥8, Imrie score ≥3, or C-reactive protein concentration >150 mg/L) gallstone pancreatitis without cholangitis were assessed for eligibility in 26 hospitals in the Netherlands. Patients were randomly assigned (1:1) by a web-based randomisation module with randomly varying block sizes to urgent ERCP with sphincterotomy (within 24 h after hospital presentation) or conservative treatment. The primary endpoint was a composite of mortality or major complications (new-onset persistent organ failure, cholangitis, bacteraemia, pneumonia, pancreatic necrosis, or pancreatic insufficiency) within 6 months of randomisation. Analysis was by intention to treat. This trial is registered with the ISRCTN registry, ISRCTN97372133.FINDINGS: Between Feb 28, 2013, and March 1, 2017, 232 patients were randomly assigned to urgent ERCP with sphincterotomy (n=118) or conservative treatment (n=114). One patient from each group was excluded from the final analysis because of cholangitis (urgent ERCP group) and chronic pancreatitis (conservative treatment group) at admission. The primary endpoint occurred in 45 (38%) of 117 patients in the urgent ERCP group and in 50 (44%) of 113 patients in the conservative treatment group (risk ratio [RR] 0·87, 95% CI 0·64-1·18; p=0·37). No relevant differences in the individual components of the primary endpoint were recorded between groups, apart from the occurrence of cholangitis (two [2%] of 117 in the urgent ERCP group vs 11 [10%] of 113 in the conservative treatment group; RR 0·18, 95% CI 0·04-0·78; p=0·010). Adverse events were reported in 87 (74%) of 118 patients in the urgent ERCP group versus 91 (80%) of 114 patients in the conservative treatment group.INTERPRETATION: In patients with predicted severe gallstone pancreatitis but without cholangitis, urgent ERCP with sphincterotomy did not reduce the composite endpoint of major complications or mortality, compared with conservative treatment. Our findings support a conservative strategy in patients with predicted severe acute gallstone pancreatitis with an ERCP indicated only in patients with cholangitis or persistent cholestasis.FUNDING: The Netherlands Organization for Health Research and Development, Fonds NutsOhra, and the Dutch Patient Organization for Pancreatic Diseases.

Published
2020

8. EUS-GUIDED GASTROJEJUNOSTOMY SHOWS HIGHER CLINICAL SUCCESS AND LOWER DYSFUNCTION RATE IN COMPARISON WITH DUODENAL STENTS IN MALIGNANT GASTRIC OUTLET OBSTRUCTION: AN INTERNATIONAL MULTICENTER PROPENSITY SCORE MATCHED COMPARISON

Author

Peter de Gooyer, Giuseppe Vanella, Michiel Bronswijk, Francesco Vito Mandarino, Paul Fockens, Wim Laleman, Hannah Van Malenstein, Giuseppe Dell'Anna, Roy V. Wanrooij, Paolo G. Arcidiacono, Schalk Van Der Merwe, and Rogier P. Voermans

Subjects
Gastroenterology, Radiology, Nuclear Medicine and imaging
Published
2022

10. PERORAL ENDOSCOPIC MYOTOMY VERSUS PNEUMATIC DILATION IN TREATMENT-NAIVE PATIENTS WITH ACHALASIA: 5-YEAR RESULTS OF A RANDOMIZED CLINICAL TRIAL

Author

Thijs Kuipers, Fraukje A. Ponds, Paul Fockens, Barbara A. Bastiaansen, Aaltje Lei, Horst Neuhaus, Torsten Beyna, Jennis Kandler, Thomas Frieling, Philip Wai Yan W. Chiu, Justin C. Wu, Vivien Wong, Guido Costamagna, Pietro Familiari, Peter J. Kahrilas, John E. Pandolfino, Andreas J. Smout, and Arjan Bredenoord

Subjects
Gastroenterology, Radiology, Nuclear Medicine and imaging
Published
2022

12. Laparoscopic versus EUS-guided gastroenterostomy for gastric outlet obstruction: An international multicenter propensity score-matched comparison

Author

Paul Fockens, Michiel Bronswijk, G Vanella, P.G. Arcidiacono, S. van der Merwe, Freek Daams, Baki Topal, Rogier P. Voermans, Wim Laleman, J. Jaekers, H. van Malenstein, R.L.J. van Wanrooij, Alberto Larghi, and M.G. Besselink

Subjects
medicine.medical_specialty, Hepatology, business.industry, medicine.medical_treatment, Endocrinology, Diabetes and Metabolism, Propensity score matching, medicine, Gastroenterology, Gastric outlet obstruction, Gastroenterostomy, business, medicine.disease, Surgery
Published
2021

13. ID: 3521776 CASE-MIX ADJUSTMENT TO COMPARE COLONOSCOPY PERFORMANCE BETWEEN ENDOSCOPY SERVICES: A NATIONWIDE COHORT STUDY

Author

Rob J. Ouwendijk, A. van der Beek, Aura A. J. van Esch, Janneke Wilschut, Thalia Hummel, Arthur K.E. Elfrink, Peter J. van der Schaar, Manon van der Vlugt, Manon C.W. Spaander, Michiel Ledeboer, Monique E. van Leerdam, J. Nass, Evelien Dekker, Marc A. Verhagen, C.L. van den Brand, Paul Fockens, and Michel W.J.M. Wouters

Subjects
medicine.medical_specialty, Case mix index, medicine.diagnostic_test, business.industry, General surgery, Gastroenterology, Medicine, Colonoscopy, Radiology, Nuclear Medicine and imaging, business, Endoscopy, Cohort study
Published
2021

14. ID: 3520219 A RANDOMIZED TRIAL OF AGGRESSIVE FLUID HYDRATION TO PREVENT POST-ERCP PANCREATITIS (FLUYT)

Author

Harry van Goor, Willem J. Thijs, Hester C. Timmerhuis, Erwin-Jan M. van Geenen, Muhammed Hadithi, Abha Bhalla, Sven M. van Dijk, David W da Costa, Lubbertus C. Baak, J.M. Vrolijk, Xavier J N M Smeets, Ruud L. Sperna Weiland, Tom C.J. Seerden, Ben J.M. Witteman, Yolande C.A. Keulemans, Nora D L Hallensleben, Hjalmar C. van Santvoort, Marc G. Besselink, Alexander C. Poen, Jeanin E. van Hooft, Adriaan C.I.T.L. Tan, Tessa E H Römkens, Paul Fockens, Christa J. Sperna Weiland, Roy L.J. van Wanrooij, W van de Vrie, Wietske Kievit, Devica S Umans, Robert C. Verdonk, Joost P.H. Drenth, Thomas R. de Wijkerslooth, Marco J. Bruno, Matthijs P. Schwartz, Brechje C van Eijck, Annet M. C. J. Voorburg, Peter J. van der Schaar, and Niels G. Venneman

Subjects
medicine.medical_specialty, Randomized controlled trial, law, business.industry, Gastroenterology, Medicine, Radiology, Nuclear Medicine and imaging, business, Post ercp pancreatitis, law.invention, Surgery
Published
2021

16. Response

Author

Victorine H. Roos, Arthur S. Aelvoet, Barbara A.J. Bastiaansen, Paul Fockens, Evelien Dekker, Gastroenterology and Hepatology, Graduate School, APH - Methodology, APH - Personalized Medicine, CCA - Imaging and biomarkers, CCA - Cancer Treatment and Quality of Life, and Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
Gastroenterology, Radiology, Nuclear Medicine and imaging
Published
2021

17. Expert consensus on endoscopic papillectomy using a Delphi process

Author

Guido Costamagna, Rogier P. Voermans, Eisuke Iwasaki, Michael J. Bourke, Jeska A. Fritzsche, Marc Giovannini, Jeong Youp Park, Marco J. Bruno, Gregory B. Haber, Jong Jin Hyun, Robert H. Hawes, Horst Neuhaus, Leena Kylänpää, David L. Carr-Locke, Takao Itoi, Gregory A. Cote, D. Nageshwar Reddy, Paul Fockens, Arata Sakai, Pierre Henri Deprez, Marc Barthet, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Service de gastro-entérologie, Gastroenterology and Hepatology, Graduate School, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology & Hepatology, II kirurgian klinikka, and HUS Abdominal Center

Subjects
Endoscopic ultrasound, Ampulla of Vater, medicine.medical_specialty, Consensus, Delphi Technique, Concordance, Common Bile Duct Neoplasms, Perforation (oil well), Endoscopic mucosal resection, RETROGRADE CHOLANGIOPANCREATOGRAPHY, 03 medical and health sciences, 0302 clinical medicine, RECTAL NSAIDS, medicine, Humans, Radiology, Nuclear Medicine and imaging, Sampling (medicine), RISK, Magnetic resonance cholangiopancreatography, medicine.diagnostic_test, business.industry, General surgery, AGGRESSIVE HYDRATION, Gastroenterology, Papillary Adenoma, SNARE PAPILLECTOMY, Endoscopy, AMPULLARY TUMORS, 3. Good health, Treatment Outcome, 3121 General medicine, internal medicine and other clinical medicine, 030220 oncology & carcinogenesis, PANCREATIC STENT PLACEMENT, LACTATED RINGERS SOLUTION, SUBMUCOSAL INJECTION, TRIAL, 030211 gastroenterology & hepatology, business
Abstract

Background and Aims: Consensus regarding an optimal algorithm for endoscopic treatment of papillary adenomas has not been established. We aimed to assess the existing degree of consensus among international experts and develop further concordance by means of a Delphi process. Methods: Fifty-two international experts in the field of endoscopic papillectomy were invited to participate. Data were collected between August and December 2019 using an online survey platform. Three rounds were conducted. Consensus was defined as >= 70% agreement. Results: Sixteen experts (31%) completed the full process, and consensus was achieved on 47 of the final 79 statements (59%). Diagnostic workup should include at least an upper endoscopy using a duodenoscope (100%) and biopsy sampling (94%). There should be selected use of additional abdominal imaging (75%-81%). Patients with (suspected) papillary malignancy or over 1 cm intraductal extension should be referred for surgical resection (76%). To prevent pancreatitis, rectal nonsteroidal anti-inflammatory drugs should be administered before resection (82%) and a pancreatic stent should be placed (100%). A biliary stent is indicated in case of ongoing bleeding from the papillary region (76%) or concerns for a (micro)perforation after resection (88%). Follow-up should be started 3 to 6 months after initial papillectomy and repeated every 6 to 12 months for at least 5 years (75%). Conclusions: This is the first step in developing an international consensus-based algorithm for endoscopic management of papillary adenomas. Surprisingly, in many areas consensus could not be achieved. These aspects should be the focus of future studies.

Published
2021

18. PC.01.1 LAPAROSCOPIC VERSUS EUS-GUIDED GASTROENTEROSTOMY FOR GASTRIC OUTLET OBSTRUCTION: AN INTERNATIONAL MULTICENTER PROPENSITY SCORE-MATCHED COMPARISON

Author

Freek Daams, M.G. Besselink, Baki Topal, G Vanella, P.G. Arcidiacono, Alberto Larghi, Paul Fockens, J. Jaekers, R.L.J. van Wanrooij, Michiel Bronswijk, Wim Laleman, Rogier P. Voermans, S. van der Merwe, and H. van Malenstein

Subjects
medicine.medical_specialty, Hepatology, business.industry, medicine.medical_treatment, Propensity score matching, Gastroenterology, Medicine, Gastric outlet obstruction, business, medicine.disease, Gastroenterostomy, Surgery
Published
2021

19. ID: 3523918 A CORE CURRICULUM FOR BASIC EUS SKILLS - AN INTERNATIONAL CONSENSUS USING THE DELPHI METHODOLOGY

Author

L Brink, Paolo Giorgio Arcidiacono, John Gásdal Karstensen, Peter Vilmann, Anand V. Sahai, Maor Lahav, Michael Bau Mortensen, Surinder Singh Rana, Evangelos Kalaitzakis, Andrew Y. Wang, Manoop S. Bhutani, Serta Kilincalp, Vijay Sharma, Aleksei Epshtein, Everson L.A. Artifon, Adrian Saftoiu, Sundeep Lakhtakia, Saad Haque, Uzma D. Siddiqui, Lars Konge, Lars Aabakken, Stephen P. Pereira, Laurent Palazzo, Enrique Vazquez-Sequeiros, Harry R. Aslanian, Michael B. Kimmey, Stephan Hollerbach, Michael Larsen, Anthony Yuen Bun Teoh, Christoph F. Dietrich, Todd H. Baron, Paul Frost Clementsen, James M. Scheiman, Takao Itoi, Jeanin E. van Hooft, Christian Jenssen, Siyu Sun, Elke Burmester, Leonardo Sosa-Valencia, Michael J. Levy, John M. DeWitt, Maria Chiara Petrone, Manuel Perez-Miranda, Mariana Jinga, Mark Topazian, Rabindra R. Watson, Maxime Palazzo, Shou-Jiang Tang, Can Gonen, Paul Fockens, Erwin Santo, Vikram Bhatia, Khanh Pham, Michael Hocke, Vitor Arantes, Rajesh N. Keswani, Vanessa M. Shami, Julio Iglesias-Garcia, Roald Flesland Havre, Linda S. Lee, Girish Mishra, Pierre Henri Deprez, Mohammad A. Al-Haddad, Jan-Werner Poley, Riadh Sadik, Timothy A. Woodward, Vinay Dhir, Pietro Fusaroli, Pramod Kumar Garg, Leizl Joy Nayahangan, Erik H.F.M. van der Heijden, Erwan Bories, and Fauze Maluf-Filho

Subjects
Medical education, business.industry, Gastroenterology, Delphi method, Medicine, Radiology, Nuclear Medicine and imaging, business, Core curriculum
Published
2021

20. ID: 3518587 ENDOSCOPIC PAPILLECTOMY; A DELPHI CONSENSUS

Author

Leena Kylänpää, Gregory A. Cote, Robert H. Hawes, Rogier P. Voermans, Jeska A. Fritzsche, Michael J. Bourke, Marc Barthet, Horst Neuhaus, Eisuke Iwasaki, Jong Jin Hyun, Marco J. Bruno, Gregory B. Haber, David L. Carr-Locke, Takao Itoi, Jeong Youp Park, Paul Fockens, Nageshwar D. Reddy, Marc Giovannini, Pierre Henri Deprez, Guido Costamagna, and Arata Sakai

Subjects
medicine.medical_specialty, business.industry, Gastroenterology, medicine, Radiology, Nuclear Medicine and imaging, Medical physics, business, computer, Delphi, computer.programming_language
Published
2021

21. ID: 3519933 LUMEN-APPOSING METAL STENTS VERSUS DOUBLE-PIGTAIL PLASTIC STENTS IN THE ENDOSCOPIC STEP-UP APPROACH FOR INFECTED NECROTIZING PANCREATITIS

Author

Niels G. Venneman, Casper H.J. van Eijck, Muhammed Hadithi, Erwin-Jan M. van Geenen, Jeanin E. van Hooft, Stefan A.W. Bouwense, Cornelis H. C. Dejong, Lotte Boxhoorn, Christina J Sperna Weiland, Marja A. Boermeester, Lars E. Perk, Wouter L. Curvers, Maarten A J M Jacobs, Robert C. Verdonk, Jan-Werner Poley, Marc G. Besselink, Marco J. Bruno, Rogier P. Voermans, Hjalmar C. van Santvoort, Hester C. Timmerhuis, Michiel Ledeboer, Vincent B. Nieuwenhuijs, Roy L.J. van Wanrooij, Ben J.M. Witteman, Frank P. Vleggaar, Thomas L. Bollen, Eva Kouw, Rutger Quispel, Martijn W J Stommel, Sjoerd D. Kuiken, Wouter L. Hazen, Vincent C. Cappendijk, Devica S Umans, Hendrik M. van Dullemen, P. Honkoop, Rogier de Ridder, Sven M. van Dijk, and Paul Fockens

Subjects
Pigtail, medicine.medical_specialty, business.industry, Gastroenterology, medicine, Lumen (anatomy), Radiology, Nuclear Medicine and imaging, business, Necrotizing pancreatitis, Surgery
Published
2021

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

Author

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, 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, null Bedin, V. Vladimir, Arpad Ivanecz, Adelmo Antonucci, Jones A.O. Omoshoro-Jones, Richard Nakache, Marco Del Chiaro, Marianne Johnstone, Tomoaki Saito, Gianpaolo Balzano, 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, 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., Levy, P., Oppong, K., Gardner, T. B., Wilcox, C. M., French, J., Steer, M., Bradley, E. L., Layer, P., Napoleon, B., Mosquera, J. A., Gouma, D. J., Andersson, R., Manzelli, A., Klaase, J. M., Falconi, M., de-Madaria, E., Casadei, R., Malleo, G., Pezzilli, R., Malecka-Panas, E., Lohr, M., Mayerle, J., Rauws, E. A. J., Freeman, M. L., Ariffin, A. C., Vasavada, B., Lai, P. B. -S., Beristain-Hernandez, J. L., Juan, A., Plaudis, H., Vrochides, D., Neri, V., Velayutham, V., Andrianov, A., Figueras, J., Soreide, K., Shcherba, A., Gachabayov, M., Keith, R. G., Tsoulfas, G., Fink, M. A., Crippa, S., Nikfarjam, M., Bora, D., Desai, R., Donati, M., Bong, J. J., Martinez Moneo, E., Morris-Stiff, G., Coker, A., de Resende, A. P., Bhalerao, S. S., Sikora, S. S., Kelemen, D., Czako, L., Ramesh, H., Rummo, O., Fedaruk, A., Hlinnik, A., Chinthakindi, M., Dumitrascu, T., Egorov, V., Bettschart, V., Molinari, M., Guillermo, E. A. D., Orloff, S. L., Kostov, D. V., Sulpice, L., Knowles, B., Kimura, Y., Marangoni, G., Joshi, R., Gyokeres, T., Bedin, Vladimir, V., Ivanecz, A., Antonucci, A., Omoshoro-Jones, J. A. O., Nakache, R., Del Chiaro, M., Johnstone, M., Saito, T., Balzano, G., Chooklin, S., Boraschi, P., Park, W., Pereira, P. N. V. R., Pagano, N., Lykoudis, P., Partecke, L. I., Siatkouski, A., Martin, R. J., Kawabata, Y., Lourenco, L. C., Marra-Lopez, C., Lee, J. K., Habbe, N., Verdonk, R. C., Rabotyagova, Y., Talukdar, R., Frulloni, L., Galeev, S., Berger, Z., Yasuda, T., Hackert, T., Saatov, Z., Raptis, D. A., Boadas, J., Vitali, F., Archibugi, L., Ryska, M., Tihanyi, B., Singh, V. K., Masamune, A., Yeaton, P., Smith, K. D., Modi, S., Cosen-Binker, L., Barreto, S. G., Morandi, E., Valeri, S., Morioka, C. Y., Lara, L. F., Takeyama, Y., Gress, F. G., Yu, Y. -D., Gaia, E., Barbu, S. T., Ince, A. T., Deeprasertvit, A., Chang, Y. -T., Abiola, S. O., Kacar, S., Muscarella, P., Braat, H., Han, S., Aghdassi, A. A., Frossard, J. -L., Smith, J. P., Schwartz, M. P., van Dullemen, H. M., Venneman, N. G., Spanier, B. W. M., Kuiken, S., van Geenen, E., Beilman, G., Papachristou, G., Chapa Azuela, O., van der Schaar, P., Oruc, N., Anten, M. -P., Nealon, W. H., Garcia-Cano, J., Jovani, M., Melki, Z., Ibrahim, M. M. A., Awajdarip, M. U., Azam, M., Sabu, K. G., Ermolaev, I., Shetty, S., Oana, B., Pokrotnieks, J., Lazuchiewicz-Kot, M., Bouali, R., Winiarski, M., Schmitt, M., Rimbas, M., Meining, A., Erwan, B., Meier, P. N., Schoefl, R., Altonbary, A. Y., Marsteller, I., Wallstabe, I., Prifti, S., Lemmers, A., Horvath, M., Kumar, A., Palermo, J. J., Surgery, Amsterdam institute for Infection and Immunity, Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, CCA - Cancer Treatment and Quality of Life, CCA - Imaging and biomarkers, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, Cancer Center Amsterdam, APH - Methodology, AII - Infectious diseases, 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, Ro, Conneely, John B., Berrevoet, Frederik, Sousa Silva, Donzã­lia, Zong-Fang, Li, Lã©vy, Philippe, Oppong, Kofi, Gardner, Timothy B., Wilcox, C. Mel, French, Jeremy, Steer, Michael, Bradley, Edward L., Layer, Peter, Napoleon, Bertrand, Mosquera, Jorge Antonio, Andersson, Roland, Manzelli, Antonio, Falconi, Massimo, de-Madaria, Enrique, Casadei, Riccardo, Malleo, Giuseppe, Pezzilli, Raffaele, Malecka-Panas, Ewa, Lohr, Matthia, Mayerle, Julia, Rauws, Erik A. J., Freeman, Martin L., Ariffin, Affirul Chairil, Vasavada, Bhavin, Lai, Paul Bo-San, Beristain-Hernandez, Jose Lui, Juan, à lvarez, Plaudis, Harald, Vrochides, Dionisio, Neri, Vincenzo, Velayutham, Vimalraj, Andrianov, Aleksey, Figueras, Joan, Soreide, Kjetil, Shcherba, Aliaksei, Gachabayov, Mahir, Keith, Roger G., Tsoulfas, Georgio, 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, Dezså, Czakã³, Lã¡szlã³, Ramesh, Hariharan, Rummo, Oleg, Fedaruk, Aliaksei, Hlinnik, Alexey, Chinthakindi, Madhusudhan, Dumitrascu, Traian, Egorov, Vyacheslav, Bettschart, Vincent, Molinari, Michele, Guillermo, E. Aldana D., Orloff, Susan L., Kostov, Daniel Vasilev, Sulpice, Laurent, Knowles, Brett, Kimura, Yasutoshi, Marangoni, Gabriele, Joshi, Rajeev, Gyã¶keres, Tibor, Bedin, Null, Ivanecz, Arpad, Antonucci, Adelmo, Omoshoro-Jones, Jones A. O., Nakache, Richard, Del Chiaro, Marco, Johnstone, Marianne, Saito, Tomoaki, Balzano, Gianpaolo, Chooklin, Serge, Boraschi, Piero, Park, Walter, Pereira, Pedro Nuno Valente Rei, Pagano, Nico, Lykoudis, Pavlo, Partecke, Lars Ivo, Siatkouski, Aliaksandr, Martã­n, Rosa Jorba, Kawabata, Yasunari, Lourenã§o, Luís Carvalho, Marra-Lopez, Carlo, Lee, Jun Kyu, Habbe, Nil, Verdonk, Robert C., Rabotyagova, Yliya, Talukdar, Rupjyoti, Frulloni, Luca, Galeev, Shamil, Berger, Zoltã¡n, Yasuda, Takeo, Hackert, Thilo, Saatov, Ziyovuddin, Raptis, Dimitri Aristotle, Boadas, Jaume, Vitali, Francesco, Archibugi, Livia, Ryska, Miroslav, Tihanyi, Balaz, 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., Young-Dong, Yu, Gaia, Ezio, Barbu, Sorin Traian, Ä°nce, Ali Tüzün, Deeprasertvit, Akkraporn, Chang, Yu-Ting, Abiola, Stephen Olusola, Kacar, Sabite, Muscarella, Peter, Braat, Henri, Han, Samuel, Aghdassi, Ali A., Frossard, Jean-Loui, Smith, Jill P., Kuiken, Sjoerd, van Geenen, Erwin, Beilman, Greg, Papachristou, Georgio, Chapa Azuela, Oscar, Oruc, Nevin, Anten, Marie-Paule, Nealon, William H., García-Cano, Jesãº, Jovani, Manol, Melki, Ziad, Ibrahim, Mustafa Mohammed Ahmed, Azam, Mohammad, Ermolaev, Igor, Shetty, Shiran, Oana, Belei, Pokrotnieks, Juri, Lazuchiewicz-Kot, Malgorzata, Bouali, Riadh, Winiarski, Marek, Schmitt, Marcu, Rimbas, Mihai, Meining, Alexander, Erwan, Borie, Meier, Peter N., Schoefl, Rainer, Altonbary, Ahmed Youssef, Marsteller, Igor, Wallstabe, Ingo, Prifti, Skerdi, Lemmers, Arnaud, Kumar, Ajay, Palermo, Joseph J., and Gastroenterology & Hepatology

Subjects
Endoscopic ultrasound, medicine.medical_treatment, Islets of Langerhans Transplantation, Practice Patterns, Diagnosis, treatment, chronic pancreatitis, survey, Bioinformatics, 0302 clinical medicine, Risk Factors, Lithotripsy, Diagnosis, 03.02. Klinikai orvostan, Endoscopy, Digestive System, Chronic, Practice Patterns, Physicians', Tomography, Digestive System Surgical Procedures, treatment, medicine.diagnostic_test, Gastroenterology, Magnetic Resonance Imaging, X-Ray Computed, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Predictive value of tests, Pancreatectomy, 030211 gastroenterology & hepatology, Autologous, medicine.medical_specialty, Clinical Decision-Making, Transplantation, Autologous, Decision Support Techniques, chronic pancreatitis, 03 medical and health sciences, Predictive Value of Tests, Pancreatitis, Chronic, medicine, Humans, survey, Pancreatic duct, Transplantation, Physicians', Hepatology, business.industry, General surgery, Gastroenterologists, Endoscopy, Magnetic resonance imaging, medicine.disease, Pancreatitis, Health Care Surveys, Tomography, X-Ray Computed, business, Digestive System
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 Buchler (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.

Published
2017

23. T06.02.3 ADVERSE EVENTS ASSOCIATED WITH LUMEN APPOSING METAL STENT PLACEMENT FOR PANCREATIC FLUID COLLECTION DRAINAGE: INTERNATIONAL MULTICENTER COMPREHENSIVE STUDY

Author

Edoardo Troncone, Arvind J. Trindade, Alessandro Fugazza, W. Uwe, Petros C. Benias, A. Bogte, C.D. Packey, Cecilia Binda, Frank P. Vleggaar, M.A. Khashab, Geoffroy Vanbiervliet, B. Martínez, A. Repici, A. Anderloni, J. Devlin, Carlo Fabbri, Ilaria Tarantino, Pierre Henri Deprez, José Ramón Aparicio, Dario Ligresti, C. Paiji, A. Charachon, Loredana Correale, Paul Fockens, Rogier P. Voermans, Y. El-Sherif, Amrita Sethi, and Douglas G. Adler

Subjects
medicine.medical_specialty, Stent placement, Hepatology, Pancreatic Fluid, business.industry, Gastroenterology, medicine, Drainage, Adverse effect, business, Surgery, Lumen (unit)
Published
2020

24. 493 ENDOSCOPIC FULL-THICKNESS RESECTION IS FEASIBLE FOR T1 COLORECTAL CANCERS - A DUTCH NATIONWIDE PROSPECTIVE REGISTRY COHORT STUDY

Author

Frank C. Bekkering, Lennard Gilissen, Matthijs P. Schwartz, Krijn Haasnoot, Maxime E. S. Bronzwaer, Rogier ten Hove, Lars R. Perk, Liselotte W. Zwager, Hedwig van der Sluis, Dimitri Heine, Bas L. Weusten, Hugo J. Wolters, Jurjen J. Boonstra, Bas W van der Spek, Paul Fockens, Svend T. Rietdijk, Jochim S. Terhaar sive Droste, Barbara A. J. Bastiaansen, Wouter B. Nagengast, and Evelien Dekker

Subjects
medicine.medical_specialty, business.industry, General surgery, Gastroenterology, medicine, Radiology, Nuclear Medicine and imaging, Full thickness resection, business, Cohort study
Published
2020

25. Diagnosis of disrupted and disconnected pancreatic duct in acute pancreatitis: a systematic review

Author

J. E. van Hooft, Miguel Bruno, Rogier P. Voermans, Hester C. Timmerhuis, M.G. Besselink, H.C. van Santvoort, SM van Dijk, T.L. Bollen, R.C. Verdonk, and Paul Fockens

Subjects
Pancreatic duct, medicine.medical_specialty, medicine.anatomical_structure, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, Acute pancreatitis, medicine.disease, business
Published
2020

26. Fr289 POSTPONED OR IMMEDIATE DRAINAGE OF INFECTED NECROTIZING PANCREATITIS (POINTER): A MULTICENTER RANDOMIZED TRIAL

Author

Jan-Werner Poley, Niels G. Venneman, Michiel F. G. Francken, Janneke van Grinsven, Rogier P. Voermans, Muhammed Hadithi, Tom C.J. Seerden, Rutger Quispel, Nora D L Hallensleben, Casper H.J. van Eijck, Marja A. Boermeester, Hjalmar C. van Santvoort, Cornelis H. C. Dejong, Lotte Boxhoorn, Thomas L. Bollen, Maarten A J M Jacobs, Marc G. Besselink, Marco J. Bruno, Marcel C. G. van de Poll, Ben J.M. Witteman, Stefan A.W. Bouwense, Robert C. Verdonk, Jeroen M. Jansen, Marcel G. W. Dijkgraaf, Krijn P. van Lienden, Eric R. Manusama, Paul Fockens, Matthijs P. Schwartz, Sven M. van Dijk, W van de Vrie, Marnix P. M. Kop, Peter van Duijvendijk, Quintus Molenaar, Hester C. Timmerhuis, Jan Willem A Straathof, Harry van Goor, Vincent B. Nieuwenhuijs, Vincent C. Cappendijk, J.S.D. Mieog, Martijn W J Stommel, Jan illem Haveman, Alexander C. Poen, and Tessa E H Römkens

Subjects
medicine.medical_specialty, Hepatology, Randomized controlled trial, law, business.industry, Pointer (computer programming), Gastroenterology, Medicine, Drainage, business, Necrotizing pancreatitis, law.invention, Surgery
Published
2021

27. Sa283 ENDOSCOPIC VERSUS SURGICAL STEP-UP APPROACH FOR INFECTED NECROTIZING PANCREATITIS: LONG-TERM FOLLOW-UP OF A MULTICENTER RANDOMIZED CONTROLLED TRIAL (EXTENSION)

Author

Stefan A.W. Bouwense, Marcel Spanier, Maarten Meijssen, Niels G. Venneman, Matthijs P. Schwartz, Koop Bosscha, Roy L.J. van Wanrooij, Jan illem Haveman, Robin Timmer, Jan Willem A Straathof, Frank P. Vleggaar, Janneke van Grinsven, Helma M.U. van Grevenstein, Thomas L. Bollen, Jeroen M. Jansen, Marja A. Boermeester, Robert C. Verdonk, Joris J. Scheepers, Sijbrand Hofker, Rogier de Ridder, Cornelis H. C. Dejong, Tom C.J. Seerden, Rogier P. Voermans, Esther C. J. Consten, Lotte Boxhoorn, Hjalmar C. van Santvoort, Jan-Werner Poley, Marco J. Bruno, Marc G. Besselink, Tessa E H Römkens, Hester C. Timmerhuis, Sandra van Brunschot, Simon Bac, Rutger Quispel, Vincent B. Nieuwenhuijs, Ben J.M. Witteman, Casper H.J. van Eijck, Harry van Goor, Marcel G. W. Dijkgraaf, Vincent C. Cappendijk, Krijn P. van Lienden, Paul Fockens, Anke M. Onnekink, and G. Willemien Erkelens

Subjects
medicine.medical_specialty, Hepatology, Randomized controlled trial, business.industry, law, Long term follow up, Gastroenterology, Medicine, business, Necrotizing pancreatitis, law.invention, Surgery
Published
2021

28. Postponed or Immediate Drainage of Infected Necrotizing Pancreatitis (POINTER): A Multicenter Randomized Trial

Author

Matthijs P. Schwartz, H. van Goor, Jeroen M. Jansen, Jan Willem Haveman, P. van Duijvendijk, C.H.J. van Eijck, J. van Grinsven, T.L. Bollen, Marcel G. W. Dijkgraaf, R.C. Verdonk, Jan Willem A Straathof, Eric R. Manusama, Niels G. Venneman, Paul Fockens, Alexander C. Poen, Hester C. Timmerhuis, Tom C.J. Seerden, Miguel Bruno, K.P. van Lienden, Ben J.M. Witteman, Tessa E H Römkens, M.G. Besselink, Lotte Boxhoorn, Nora D L Hallensleben, M Hadithi, H.C. van Santvoort, Marja A. Boermeester, J.S.D. Mieog, Marnix P. M. Kop, SM van Dijk, and Rutger Quispel

Subjects
medicine.medical_specialty, Hepatology, Randomized controlled trial, law, business.industry, Pointer (computer programming), Gastroenterology, Medicine, Drainage, Necrotizing pancreatitis, business, law.invention, Surgery
Published
2021

30. Systematic review and meta-analysis on the prevalence of vitamin D deficiency in patients with chronic pancreatitis

Author

Sanne A. Hoogenboom, Selma J. Lekkerkerker, Paul Fockens, J. E. van Hooft, and Marja A. Boermeester

Subjects
Vitamin, medicine.medical_specialty, Malabsorption, Hepatology, business.industry, Endocrinology, Diabetes and Metabolism, Osteoporosis, Gastroenterology, Odds ratio, medicine.disease, vitamin D deficiency, 03 medical and health sciences, Malnutrition, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, chemistry, 030220 oncology & carcinogenesis, Internal medicine, medicine, Vitamin D and neurology, 030211 gastroenterology & hepatology, business, Exocrine pancreatic insufficiency
Abstract

Patients with chronic pancreatitis (CP) are at risk of malnutrition due to malabsorption, pain and/or alcohol consumption. This can cause vitamin D insufficiency or deficiency, which is associated with osteoporosis and increased risks of fractures. We aimed to perform a meta-analysis to determine the prevalence of vitamin D insufficiency and deficiency in CP patients. Furthermore, we compared these results with healthy controls. We performed a systematic review and meta-analysis on the literature by searching PubMed and EMBASE (January 2000-December 2015) on CP and vitamin D. Primary outcome was prevalence of vitamin D insufficiency ( 0.05). There is a high prevalence of vitamin D insufficiency and deficiency in CP patients. Nevertheless, there is no significant difference in prevalence of vitamin D insufficiency and deficiency compared to healthy controls. Further research should indicate the clinical relevance and consequences of these findings for clinical practice

Published
2016

31. Tu1132 ASSOCIATION BETWEEN THE ADENOMA DETECTION RATE AND A COMPOSITE QUALITY INDICATOR OF CAECAL INTUBATION, PATIENT COMFORT AND SEDATION IN FIT-POSITIVE COLONOSCOPIES

Author

Sascha C. van Doorn, Karlijn J. Nass, Paul Fockens, Manon van der Vlugt, and Evelien Dekker

Subjects
Adenoma, business.industry, medicine.medical_treatment, Sedation, media_common.quotation_subject, Gastroenterology, medicine.disease, Anesthesia, Medicine, Intubation, Radiology, Nuclear Medicine and imaging, Quality (business), medicine.symptom, Detection rate, business, media_common, Patient comfort
Published
2020

32. 897 RISK-STRATIFIED COMPARISON OF BRIDGE TO SURGERY APPROACHES VERSUS EMERGENCY RESECTION IN PATIENTS WITH LEFT-SIDED OBSTRUCTIVE COLON CANCER: A NATIONWIDE STUDY

Author

Peter D. Siersema, Emo E. van Halsema, Joyce V. Veld, Femke J. Amelung, Wernard A. A. Borstlap, Esther C. J. Consten, Frank ter Borg, Paul Fockens, Edwin S. van der Zaag, Jeanin E. van Hooft, Pieter J. Tanis, and Willem A. Bemelman

Subjects
medicine.medical_specialty, Hepatology, business.industry, Colorectal cancer, Gastroenterology, medicine, In patient, Bridge to surgery, business, medicine.disease, Left sided, Resection, Surgery
Published
2020

33. Sa1369 DIAGNOSIS AND TREATMENT OF PANCREATIC DUCT DISRUPTION OR DISCONNECTION: AN INTERNATIONAL EXPERT SURVEY AND CASE VIGNETTE STUDY

Author

Rogier P. Voermans, Hjalmar C. van Santvoort, Robert C. Verdonk, Marc G. Besselink, Thomas L. Bollen, Hester C. Timmerhuis, B. Joseph Elmunzer, Paul Fockens, Lotte Boxhoorn, Marco J. Bruno, and Karen D. Horvath

Subjects
Pancreatic duct, medicine.medical_specialty, medicine.anatomical_structure, Hepatology, business.industry, General surgery, Gastroenterology, medicine, Case vignette, Disconnection, business
Published
2020

34. 177 DECOMPRESSING STOMA VERSUS EMERGENCY RESECTION FOR LEFT-SIDED OBSTRUCTIVE COLON CANCER: A NATIONWIDE, PROPENSITY SCORE MATCHED STUDY

Author

Joyce V. Veld, Emo E. van Halsema, Pieter J. Tanis, Wernard A. A. Borstlap, Edwin S. van der Zaag, Femke J. Amelung, Willem A. Bemelman, Esther C. J. Consten, Paul Fockens, Peter D. Siersema, Frank ter Borg, and Jeanin E. van Hooft

Subjects
medicine.medical_specialty, Hepatology, Stoma (medicine), business.industry, Colorectal cancer, Propensity score matching, Gastroenterology, Medicine, business, medicine.disease, Left sided, Resection, Surgery
Published
2020

35. Mo1362 IDENTIFYING KEY FACTORS FOR THE EFFECTIVENESS OF PANCREATIC CANCER SCREENING IN HIGH-RISK INDIVIDUALS: A MODEL-BASED ANALYSIS

Author

Sonja Kroep, Djuna L. Cahen, Femme Dirksmeier-Harinck, Jeanin E. van Hooft, Ingrid C. Konings, Inge de Kok, Paul Fockens, Brechtje D. Koopmann, Iris Lansdorp-Vogelaar, Steffie K. Naber, Marco J. Bruno, and Marjolein van Ballegooijen

Subjects
Oncology, medicine.medical_specialty, Key factors, Hepatology, business.industry, Pancreatic cancer, Internal medicine, Gastroenterology, medicine, medicine.disease, business
Published
2020

37. Updated international Cancer of the Pancreas Screening (CAPS) consortium guidelines on the management of patients with increased risk for familial pancreatic cancer

Author

Kasper Overbeek, Marcia Irene Canto, Detlef Bartsch, Randall Brand, Alfredo Carrato, Marco Del Chiaro, James Farrell, Elliot Fishman, Paul Fockens, Thomas Gress, Jeanin E. van Hooft, Fay Kastrinos, Anil Rustgi, Sapna Syngal, Hans Vasen, Djuna Cahen, Marco J. Bruno, and Michael Goggins

Subjects
Hepatology, Endocrinology, Diabetes and Metabolism, Gastroenterology
Published
2019

38. Su1737 IS DECOMPRESSING STOMA A BETTER ALTERNATIVE THAN STENT AS BRIDGE TO SURGERY FOR LEFT-SIDED OBSTRUCTIVE COLON CANCER? A NATIONWIDE, PROPENSITY SCORE MATCHED ANALYSIS

Author

Peter D. Siersema, Femke J. Amelung, Frank ter Borg, Pieter J. Tanis, Esther C. J. Consten, Paul Fockens, Joyce V. Veld, Jeanin E. van Hooft, Wernard A. A. Borstlap, Edwin S. van der Zaag, Emo E. van Halsema, and Willem A. Bemelman

Subjects
medicine.medical_specialty, Colorectal cancer, business.industry, medicine.medical_treatment, Gastroenterology, Stent, medicine.disease, Left sided, Surgery, Stoma (medicine), Propensity score matching, medicine, Radiology, Nuclear Medicine and imaging, Bridge to surgery, business
Published
2019

39. The proximal serrated polyp detection rate is an easy-to-measure proxy for the detection rate of clinically relevant serrated polyps

Author

Ymkje M. van der Brug, Barbara A. J. Bastiaansen, Joep E. G. IJspeert, Paul Fockens, Sascha C. van Doorn, Evelien Dekker, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Graduate School, Gastroenterology and Hepatology, Other departments, and CCA -Cancer Center Amsterdam

Subjects
Adenoma, Male, medicine.medical_specialty, Time Factors, Colorectal cancer, Colonic Polyps, Colonoscopy, Logistic regression, Gastroenterology, Diagnosis, Differential, Internal medicine, medicine, Humans, Mass Screening, Radiology, Nuclear Medicine and imaging, Prospective Studies, Prospective cohort study, Netherlands, medicine.diagnostic_test, business.industry, Incidence, Confounding, Reproducibility of Results, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Cross-Sectional Studies, Hyperplastic Polyp, Female, Colorectal Neoplasms, business, Follow-Up Studies
Abstract

The adenoma detection rate (ADR) is the most important surrogate quality parameter for colorectal cancer (CRC) prevention. However, serrated polyps also are precursors of CRC. Large, prospective studies comparing the detection rate of serrated polyps among endoscopists in an era of awareness about the malignant potential of serrated polyps have not yet been performed. We aimed to compare the proximal serrated polyp (PSP) detection rate and the clinically relevant serrated polyp (RSP) detection rate among endoscopists and to analyze the association between these parameters and the ADR. Colonoscopy data were retrieved in one expert center between January 2011 and July 2014 by using a structured reporting system, enabling prospective and automatic quality assessment. Endoscopists who performed at least 50 colonoscopies within the timeframe were included for analysis. Multivariate logistic regression was used to compare the ADR, PSP detection rate, and RSP detection rate among endoscopists. The association among these parameters was calculated by using the Pearson r correlation coefficient. All lesions were assessed by an expert pathologist. In total, 16 endoscopists and 2088 colonoscopies were included for analysis. The PSP detection rate ranged from 2.9% to 18.6% (mean 10.4%) among endoscopists. Corrected for confounders, the odds ratio to detect ≥1 PSP, compared with endoscopists with the highest detection rate, ranged from 0.79 (95% confidence interval [CI], 0.41-1.52) to 0.12 (95% CI, 0.03-0.55). The PSP detection rate was highly correlated with the RSP detection rate (ρ 0.94; P

Published
2015

40. 120 DIAGNOSTIC ACCURACY OF HIGH DEFINITION WHITE LIGHT, NARROW BAND IMAGING WITH OR WITHOUT NEAR FOCUS FOR ASSESSMENT OF COLORECTAL ENDOSCOPIC MUCOSAL RESECTION SCARS: ESCART TRIAL (EMR SCAR ASSESSMENT TRIAL), MULTICENTER IMAGE EVALUATION STUDY

Author

Charles J. Kahi, Eelco C. Brand, John M. Levenick, Nicholas J. Tutticci, Cesare Hassan, Michael J. Bourke, Gottumukkala S. Raju, Pujan Kandel, Jeffrey Gill, Nicholas G. Burgess, Amit Rastogi, Ammar O. Kheir, Paul Fockens, Evelien Dekker, Marselli Roberta, Douglas K. Rex, Ajay Bansal, Peter V. Draganov, Joe Pelt, William A. Ross, Manon van der Vlugt, Kristien M. A. J. Tytgat, Ian S. Grimm, Seth D. Crockett, B. Joseph Elmunzer, Dennis Yang, Michael B. Wallace, Alessandro Repici, Mohammad A. Al-Haddad, and Stuart R. Gordon

Subjects
medicine.medical_specialty, Focus (geometry), business.industry, Scar assessment, Gastroenterology, Scars, Diagnostic accuracy, Endoscopic mucosal resection, Image evaluation, White light, High definition, Medicine, Radiology, Nuclear Medicine and imaging, Radiology, medicine.symptom, business
Published
2018

41. Video-assisted Retroperitoneal Debridement (VARD) in infected necrotizing pancreatitis – 12 year experience in the Netherlands

Author

Sven van Dijk, Nora Hallensleben, Sandra van Brunschot, Janneke van Grinsven, Bob Hollemans, Hester Timmerhuis, Rogier Voermans, Marco J. Bruno, Paul Fockens, Vincent Nieuwenhuijs, Harry van Goor, Sijbrand Hofker, Cornelis Dejong, Krijn van Lienden, Casper van Eijck, Marja Boermeester, Hjalmar van Santvoort, and Marc G. Besselink

Subjects
Hepatology, Endocrinology, Diabetes and Metabolism, Gastroenterology
Published
2019

43. Patient-reported burden of intensified surveillance and surgery in high-risk individuals under pancreatic cancer surveillance

Author

Kasper Overbeek, Djuna Cahen, Anne Kamps, Ingrid Konings, Femme Harinck, Marianne Kuenen, Bas Groot Koerkamp, Marc G. Besselink, Casper van Eijck, Anja Wagner, Margreet Ausems, Manon van der Vlugt, Paul Fockens, Frank Vleggaar, Jan-Werner Poley, Jeanin E. van Hooft, Eveline Bleiker, and Marco J. Bruno

Subjects
Hepatology, Endocrinology, Diabetes and Metabolism, Gastroenterology
Published
2019

46. Mo1374 – 12 Years of Prospective Pancreatic Cancer Surveillance: Results of the Dutch Nationwide Program in High-Risk Individuals

Author

Femme Harinck, Marco J. Bruno, Kasper A. Overbeek, Anja Wagner, Manon van der Vlugt, Brechtje D. Koopmann, Iris J. Levink, Jeanin E. van Hooft, Ingrid C. Konings, Jan-Werner Poley, B. Groot Koerkamp, Djuna L. Cahen, Paul Fockens, Frank P. Vleggaar, Margreet G. E. M. Ausems, and Marc G. Besselink

Subjects
medicine.medical_specialty, Hepatology, business.industry, Pancreatic cancer, Internal medicine, Gastroenterology, medicine, medicine.disease, business
Published
2019

47. 570 – Early Endoscopic Retrograde Cholangiography with Biliary Sphincterotomy Or Conservative Treatment in Predicted Severe Acute Biliary Pancreatitis (APEC): A Multicenter Randomized Controlled Trial

Author

Marc G. Besselink, Casper H.J. van Eijck, Erwin-Jan M. van Geenen, Robert C. Verdonk, Niels G. Venneman, Nicole S. Erler, Olaf J. Bakker, Adriaan C.I.T.L. Tan, Janneke van Grinsven, Tessa E H Römkens, Hein G. Gooszen, Robert J.F. Laheij, Rogier de Ridder, Jeanin E. van Hooft, Ben J.M. Witteman, Marie-Paule Anten, Jeroen P. Jansen, Robin Timmer, Marco J. Bruno, Carola H.M. Ruigrok, G. Willemien Erkelens, Nora D L Hallensleben, Erik J. Schoon, Hjalmar C. van Santvoort, Marno C.M. Rijk, Thomas L. Bollen, Marcel Spanier, Foke van Delft, Rutger Quispel, Matthijs P. Schwartz, W van de Vrie, Nicolien J. Schepers, Willem J. Thijs, Hendrik M. van Dullemen, Marcel G. W. Dijkgraaf, René W M van der Hulst, Sjoerd D. Kuiken, Paul Fockens, Frank P. Vleggaar, and Frank J G M Kubben

Subjects
medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, law.invention, Surgery, Conservative treatment, Randomized controlled trial, law, Biliary sphincterotomy, Endoscopic retrograde cholangiography, Medicine, Biliary pancreatitis, business
Published
2019

48. Sa1350 – Updated International Cancer of the Pancreas Screening (CAPS) Consortium Guidelines on the Management of Patients with Increased Risk for Familial Pancreatic Cancer

Author

Hans F. A. Vasen, Paul Fockens, Fay Kastrinos, Thomas M. Gress, Michael Goggins, James J. Farrell, Anil K. Rustgi, Alfredo Carrato, Randall E. Brand, Elliot K. Fishman, Detlef K. Bartsch, Jeanin E. van Hooft, Kasper A. Overbeek, Marco Del Chiaro, Djuna L. Cahen, Marco J. Bruno, Sapna Syngal, and Marcia I. Canto

Subjects
Oncology, medicine.medical_specialty, Hepatology, business.industry, Gastroenterology, Cancer, medicine.disease, medicine.anatomical_structure, Increased risk, Internal medicine, Familial Pancreatic Cancer, medicine, Pancreas, business
Published
2019

49. Sa1365 – Patient-Reported Burden of Intensified Surveillance and Surgery in High-Risk Individuals Under Pancreatic Cancer Surveillance

Author

Eveline M. A. Bleiker, Paul Fockens, Jeanin E. van Hooft, Anne Kamps, Djuna L. Cahen, Femme Harinck, Marianne A. Kuenen, Jan-Werner Poley, Marc G. Besselink, B. Groot Koerkamp, Anja Wagner, Manon van der Vlugt, Ingrid C. Konings, Marco J. Bruno, Kasper A. Overbeek, Frank P. Vleggaar, and Margreet G. E. M. Ausems

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Pancreatic cancer, Gastroenterology, medicine, business, medicine.disease
Published
2019

50. Surgical management of main duct IPMN and mixed type IPMN: an international survey and case-vignette study among experts

Author

N. C. M. van Huijgevoort, M Del Chiaro, Lianne Scholten, Miguel Bruno, Suresh T. Chari, C. Fernandez del Castillo, Alain Sauvanet, Paul Fockens, J. E. van Hooft, Sohei Satoi, C.L. Wolfgang, and M.G. Besselink

Subjects
medicine.medical_specialty, Hepatology, business.industry, General surgery, International survey, medicine, Case vignette, Gastroenterology, Mixed Type IPMN, business, Main duct
Published
2019

Catalog

Books, media, physical & digital resources
See catalog results