The i-EUS consensus on EUS-guided gallbladder drainage: A 3-step modified Delphi approach.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Facciorusso Antonio, Binda Cecilia, Crinò Stefano Francesco, Lisotti Andrea, Spadaccini Marco, Amato Arnaldo, Carrozza Lucio, Catena Fausto, Cobianchi Lorenzo, Coluccio Chiara, Forti Edoardo, Fuccio Lorenzo, Ligresti Dario, Maida Marcello Fabio, Mauro Aurelio, Mazza Stefano, Mirante Vincenzo G, Rizzo Giacomo E M, Troncone Edoardo, Vanella Giuseppe, Rakichevikj Emilija, Anderloni Andrea, Fabbri Carlo, Tarantino Ilaria, Ansaloni Luca, Armellini Elia, Badas Roberta, Barbera Carmelo, Berretti Debora, Boskoski Ivo, Camellini Lorenzo, Cennamo Vincenzo, Cugia Luigi, Del Vecchio Blanco Giovanna, De Nucci Germana, Di Mitri Roberto, Di Pisa Marta, Ferrara Francesco, Fugazza Alessandro, Moutinho-Ribeiro Pedro, Macor Daniele, Marciano Emanuele, Mutignani Massimiliano, Perez Miranda Manuel, Piras Enrico, Pollino Valeria, Redaelli Alessandro Ettore, Scarcelli Antonella, Spada Cristiano, Traina Mario, Tringali Alberto, Venezia Giovanna, Fusaroli Pietro, [i-EUS Working Group]
Аннотация
METHODS: A 3-step modified Delphi process was used by the Interventional Endoscopy and Ultrasound Group, involving multidisciplinary experts in gastroenterology, surgery, and radiology. Four task forces conducted systematic literature reviews and generated PICO (Patients, Interventions, Comparator, and Outcomes)-formatted clinical questions. Evidence was graded using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) system, and consensus was defined as ≥80% agreement among panelists.
RESULTS: Twenty-two clinical questions were addressed, covering indications, timing, techniques, device selection, procedural aspects, and postprocedural care for EUS-GBD. Recommendations include the preferential use of EUS-GBD over percutaneous and transpapillary approaches in high-risk patients, early intervention in select cases, the use of lumen-apposing metal stents, and tailored postprocedural strategies. All recommendations were conditional, except for one strong recommendation in favor of EUS-GBD over other modalities, supported by moderate-quality evidence.
CONCLUSIONS: This consensus offers a comprehensive, multidisciplinary guideline for the safe and effective use of EUS-GBD in clinical practice. These recommendations aim to standardize care and support future research in this rapidly evolving field.