title: A survey of ampullectomy practices.
abstract: OBJECTIVE
  To investigate the endoscopic ampullectomy practices of expert biliary endoscopists.
  
  
  METHODS
  An anonymous survey was mailed to 79 expert biliary endoscopists to assess ampullectomy practices.
  
  
  RESULTS
  Forty six (58%) biliary endoscopists returned the questionnaire. Of these, 63% were in academia and in practice for an average of 16.4 years (+/- 8.6). Endoscopists performed an average of 1.1 (+/- 0.8) ampullectomies per month. Prior to ampullectomy, endoscopic ultrasound was "always" utilized by 67% of respondents vs "sometimes" in 31% of respondents. Empiric biliary sphincterotomy was not utilized uniformly, only 26% "always" and 37% "sometimes" performed it prior to resection. Fifty three percent reported "never" performing empiric pancreatic sphincterotomy prior to ampullectomy. Practitioners with high endoscopic retrograde cholangiopancreatography volumes were the most likely to perform a pancreatic sphincterotomy (OR = 10.9; P = 0.09). Participants overwhelmingly favored "always" placing a prophylactic pancreatic stent, with 86% placing it after ampullectomy rather than prior to resection (23%). Argon plasma coagulation was the favored adjunct modality (83%) for removal of residual adenomatous tissue. Practitioners uniformly (100%) preferred follow-up examination to be within 6 mo post-ampullectomy.
  
  
  CONCLUSIONS
  Among biliary experts, there is less variation in ampullectomy practices than is reflected in the literature.
authors.affiliation: Eastern Virginia Medical School, 885 Kempsville Rd, Suite 114, Norfolk, Virginia 23502, United States. sbartnik@gmail.com
authors.forename: Stacy B
authors.initials: SB
authors.lastname: Menees
authors.forename: Philip
authors.initials: P
authors.lastname: Schoenfeld
authors.forename: Hyungjin Myra
authors.initials: HM
authors.lastname: Kim
authors.forename: Grace H
authors.initials: GH
authors.lastname: Elta
mesh_terms: D014670:Ampulla of Vater / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000601:surgery; D010818:Practice Patterns, Physicians'; D015607:Stents; D011795:Surveys and Questionnaires; D016896:Treatment Outcome