International Expert Delphi Consensus on Endoscopic Ultrasound-Guided Portosystemic Pressure Gradient: Best Practices and Future Directions.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Wang Thomas J, Chang Kenneth, Rubin Raymond A, Salgia Reena, Shami Vanessa, Watson Andrew, Khara Harshit S, Yeaton Paul, Adler Douglas G, Bazarbashi Ahmad N, Benmassaoud Amine, Chen Yen-I, Diehl David L, Draganov Peter, Duarte-Rojo Andres, Eves Matthew, Fortune Brett E, Frandah Wesam W, Gines Angels, Gjeorgjievski Mihajlo, Henry Zachary H, James Martin, Jirapinyo Pichamol, Joshi Tejas, Kankotia Ravi, Khurana Sandeep, Kumar Sonal, Kwo Paul Y, Laleman Wim, Larghi Alberto L, Mahon Brinder S, McHenry Scott A, Mehta Minesh J, Mony Shruti, Nilsson Jan-Erick, Park Walter G, Sack Jordan, Samarasena Jason, Santopaolo Francesco, Teoh Anthony Y, Van Der Merwe Schalk, Zucker Stephen D, Ryou Marvin
Аннотация
METHODS: A steering committee developed consensus statements covering 4 domains: indications, pre-procedural protocol, intra-procedural technique, and future research. Forty-seven experts (29 advanced endoscopists, 18 hepatologists) were invited to participate via an online survey platform. Consensus for each statement was determined by ≥70% agreement on a Likert scale among participants. Statements that did not reach consensus were modified based on feedback and brought for a re-vote.
RESULTS: A total of 53 statements achieved consensus after 2 rounds. Thirty-seven experts (79% of those invited) participated in both rounds. Notable areas of consensus included the following: (1) Clinical indications for EUS-PPG include all indications for hepatic venous pressure gradient and may be preferred in suspected presinusoidal portal hypertension or when another indication for endoscopy is present (eg, variceal screening); (2) EUS-PPG is safe and well tolerated; (3) EUS-PPG should be performed under monitored anesthesia care or general anesthesia; and (4) meticulous attention to technical details is required to maximize accuracy. New research frontiers for EUS-PPG were identified.
CONCLUSIONS: The results of this modified Delphi process established expert agreement on multiple important issues and provided practical guidance on key aspects of EUS-PPG. This document could provide a roadmap for future research studies.