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Endoscopic classifi...
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Haraldsson, EKarolinska Institutet,Karolinska Institute,Skaraborg Hospital
(author)
Endoscopic classification of the papilla of Vater. Results of an inter- and intraobserver agreement study
- Article/chapterEnglish2017
Publisher, publication year, extent ...
Numbers
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LIBRIS-ID:oai:lup.lub.lu.se:a02c99c4-175d-44c2-bdaa-e03246b65862
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https://lup.lub.lu.se/record/a02c99c4-175d-44c2-bdaa-e03246b65862URI
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https://doi.org/10.1177/2050640616674837DOI
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-147739URI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:135903561URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:art swepub-publicationtype
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Subject category:ref swepub-contenttype
Notes
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Background: Many endoscopists acknowledge that the appearance of the papilla of Vater seems to affect biliary cannulation. To assess the association between the macroscopic appearance of the papilla and biliary cannulation and other related clinical issues, a system is needed to define the appearance of the papilla. Objective: The purpose of this study was to validate an endoscopic classification of the papilla of Vater by assessing the interobserver and intraobserver agreements among endoscopist with varying experience. Methods: An endoscopic classification, based on pictures captured from 140 different papillae, containing four types of papillae was proposed. The four types are (a) Type 1: regular papilla, no distinctive features, ‘classic appearance’; (b) Type 2: small papilla, often flat, with a diameter ≤ 3 mm (approximately 9 Fr); (c) Type 3: protruding or pendulous papilla, a papilla that is standing out, protruding or bulging into the duodenal lumen or sometimes hanging down, pendulous with the orifice oriented caudally; and (d) Type 4: creased or ridged papilla, where the ductal mucosa seems to extend distally, rather out of the papillary orifice, either on a ridge or in a crease. To assess the level of interobserver agreement, a web-based survey was sent out to 18 endoscopists, containing 50 sets of still images of the papilla, distributed between the four different types. Three months later a follow-up survey, with images from the first survey was sent to the same endoscopists. Results: Interobserver agreement was substantial (κ = 0.62, 95% confidence interval (CI) 0.58–0.65) and were similar for both experts and non-experts. The intraobserver agreement assessed with the second survey was also substantial (κ = 0.66, 95% CI 0.59–0.72). Conclusion: The proposed endoscopic classification of the papilla of Vater seems to be easy to use, irrespective of the level of experience of the endoscopist. It carries a substantial inter- and intraobserver agreement and now the clinical relevance of the four different papilla types awaits to be determined.
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Lundell, LarsKarolinska Institutet,Karolinska Institute,Karolinska University Hospital
(author)
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Swahn, F.Karolinska Institute,Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lever-, pankreas- och gallvägskirurgi,Forskargrupper vid Lunds universitet,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Hepato-Pancreato-Biliary Surgery,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-fks
(author)
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Enochsson, LarsKarolinska Institute,Karolinska University Hospital,Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden(Swepub:umu)laen0014
(author)
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Löhr, J. M.Karolinska Institutet,Karolinska Institute,Karolinska University Hospital
(author)
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Arnelo, UKarolinska Institutet,Karolinska Institute,Karolinska University Hospital
(author)
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Aabakken, LarsOslo university hospital
(author)
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Grönroos, JuhaTurku University Hospital
(author)
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Halttunen, JormaHelsinki University Central Hospital
(author)
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Hauge, TrulsOslo university hospital(Swepub:lu)extLU-1089
(author)
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Lindkvist, BjörnSahlgrenska Academy(Swepub:lu)kir-bl0
(author)
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Kylänpää, Marja LeenaHelsinki University Central Hospital
(author)
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Schmidt, Palle NHvidovre Hospital
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Saarela, ArtoOulu University Hospital
(author)
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Toth, ErvinLund University,Lunds universitet,Gastroenterologi,Forskargrupper vid Lunds universitet,Gastroenterology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)ront-eto
(author)
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Karolinska InstituteSkaraborg Hospital
(creator_code:org_t)
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Scandinavian Association for Digestive Endoscopy (SADE) Study Group of Endoscopic Retrograde Cholangio-Pancreaticography
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In:United European Gastroenterology Journal: Wiley5:4, s. 504-5102050-64062050-6414
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Haraldsson, E
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Lundell, Lars
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Swahn, F.
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Enochsson, Lars
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Löhr, J. M.
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Arnelo, U
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Aabakken, Lars
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Grönroos, Juha
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Halttunen, Jorma
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Hauge, Truls
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Lindkvist, Björn
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Kylänpää, Marja ...
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Schmidt, Palle N
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Saarela, Arto
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Toth, Ervin
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- MEDICAL AND HEALTH SCIENCES
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and Gastroenterology ...
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MEDICAL AND HEAL ...
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and Surgery
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Lund University
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Umeå University
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Karolinska Institutet