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Confocal endomicroscopy for evaluation of pancreatic cystic lesions: a systematic review and international Delphi consensus report
- Source :
- Endoscopy International Open, Endoscopy International Open, 08(11), E1566-E1581. Georg Thieme Verlag, Endoscopy International Open, Vol 08, Iss 11, Pp E1566-E1581 (2020)
- Publication Year :
- 2020
- Publisher :
- Georg Thieme Verlag, 2020.
-
Abstract
- Background and study aims The aim of thi systematic review and consensus report is to standardize the practice of endoscopic ultrasound (EUS-guided needle-based confocal laser endomicroscopy (nCLE) for pancreatic cystic lesion (PCL) evaluation. Methods We performed an international, systematic, evidence-based review of the applications, outcomes, procedural processes, indications, training, and credentialing of EUS-nCLE in management of PCLs. Based on available clinical evidence, preliminary nCLE consensus statements (nCLE-CS) were developed by an international panel of 15 experts in pancreatic diseases. These statements were then voted and edited by using a modified Delphi approach. An a priori threshold of 80 % agreement was used to establish consensus for each statement. Results Sixteen nCLE-CS were discussed. Thirteen (81 %) nCLE-CS reached consensus addressing indications (non-communication PCL meeting criteria for EUS-FNA or with prior non-diagnostic EUS-FNA), diagnostic outcomes (improved accuracy for mucinous PCLs and serous cystadenomas with substantial interobserver agreement of image patterns), low incidence of adverse events (fluorescein-associated and pancreatitis), procedural processes (nCLE duration, manipulation of needle with probe), and training (physician knowledge and competence). Conclusion Based on a high level of agreement pertaining to expert consensus statements, this report standardizes the practice of EUS-nCLE. EUS-nCLE should be systematically considered when EUS-FNA is indicated for PCL evaluation.
- Subjects :
- Endoscopic ultrasound
Original article
medicine.medical_specialty
education
MEDLINE
Modified delphi
Credentialing
03 medical and health sciences
Cystic lesion
0302 clinical medicine
Endomicroscopy
medicine
Pharmacology (medical)
Medical physics
lcsh:RC799-869
computer.programming_language
medicine.diagnostic_test
business.industry
medicine.disease
digestive system diseases
030220 oncology & carcinogenesis
Pancreatitis
lcsh:Diseases of the digestive system. Gastroenterology
030211 gastroenterology & hepatology
business
computer
Delphi
Subjects
Details
- Language :
- English
- ISSN :
- 21969736 and 23643722
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Endoscopy International Open
- Accession number :
- edsair.doi.dedup.....c1729168737c5dac8c381ae2dfdcfc09