HOW TO OPTIMIZE STANDARD OF CARE FOR PANCREATOBILIARY DISEASES: A NATIONWIDE ANALYSIS

Aims Aim of this survey is to investigate the current clinical and therapeutic management of patients affected by pancreatobiliary diseases nationwide, with the purpose to identify the key points needing to be strengthened, focusing on clinical outcome optimization.

Methods 38 questions were submitted online, through scientific communities network, to all Italian centers about outpatient assessment, endoscopic and surgical procedures, multidisciplinary board. The answers were prospectively reported anonymously and analyzed on a database (Excel, Open Office​).

Results 94 participants from 67 hospitals completed the survey. Only 51% of the centers has an outpatient service dedicated to pancreatobiliary disorders, and in 52% of the cases without an exclusive direct way of communication between doctors and patients. Only 48% involves regularly a multidisciplinary meeting. Cystic lesions are the most troublesome diseases among specialists. Diagnostic Endoscopic Ultrasonography (EUS) is not performed in 30% of the hospitals, therapeutic EUS in 42%, endoscopic retrograde colangiopancreatography (ERCP) in 3%. Rapid on-site evaluation is usually not available, or just in selected cases. After ERCP failure, percutaneous drainage is the most common rescue strategy of treatment. Dedicated pancreatobiliary specialists are not always guaranteed: pathologists just in 43% of hospitals, surgeons in 78%, oncologists in 54%.

Conclusions This is the first survey assessing the state of the art on clinical and therapeutic management of pancreatobiliary diseases in Italy. There is currently wide inhomogeneity nationwide, which demonstrates a pressing need to define performance indicators towards a standardization of healthcare, in the setting of a multidisciplinary teamwork.

Publication History

Article published online:
14 April 2022