A survey of ampullectomy practices

Table 1 Ampullectomy survey

1 Please list your age.

2 Gender:

Male

Female

3 Please specify your type of practice?

Private practice

Multi-specialty group

Academic practice

Health maintenance organization (HMO)

Other

4 How many years have you been in practice?

5 On average, how many ERCPs do you perform in a month?

6 On average, how many ampullectomies for ampullary adenomas do you perform in a month?

7 How often do you perform an EUS or IDUS of the ampulla prior to ampullectomy?

Always

Sometimes-if there are concerning features known ahead of time

Never

8 How often do you perform an empiric biliary sphincterotomy prior to ampullectomy?

Always

Sometimes

Never

9 How often do you perform an empiric pancreatic sphincterotomy prior to ampullectomy?

Always

Sometimes

Never

10 How often do you place a prophylactic pancreatic stent prior to ampullectomy?

Always

Sometimes

Never

11 How often do you place a prophylactic stent after ampullectomy?

Always

Never

Only if there is delayed pancreatic duct drainage or a remnant lesion close to the pancreatic orifice that needs additional treatment

12 How often do you perform a submucosal injection of the ampullary adenoma prior to resection?

Always

Sometimes

Never

13 For endoscopic ampullectomy, what type of electrosurgical currents do you use most often?

Pure coagulation current

Blended current

Pure cutting current

ERBE-adjustable current

14 What is the largest ampullary adenoma that you have removed endoscopically?

15 What adjunct modality do you use most commonly to remove residual tissue after ampullectomy?

Cold forceps biopsy

Argon plasma coagulation

Monopolar/multipolar electrocoagulation probe

Nd: YAG laser photoablation

16 In general, after ampullectomy, at what interval do you recommend a follow-up endoscopic examination?

1 mo

3 mo

6 mo

12 mo

Table 2 Respondent characteristics (mean ± SD)

Characteristic
Male, n (%)	46 (100)
Practice type, n (%)
Academic	29 (63)
Private	14 (30)
Multi-specialty group	3 (7)
Years in practice	16.4 ± 8.6
ERCPs per month	36.78 ± 26.2
Ampullectomies per month	1.1 ± 0.8

ERCP: Endoscopic retrograde cholangiopancreatography.

Table 3 Pre-ampullectomy practices

Practice	n(%)
EUS
Always	30 (67)
Sometimes	14 (31)
Never	1 (2)
Biliary sphincterotomy
Always	11 (26)
Sometimes	16 (37)
Never	16 (37)
Pancreatic sphincterotomy
Always	10 (23)
Sometimes	10 (23)
Never	23 (53)
Pancreatic stent
Always	10 (23)
Sometimes	15 (35)
Never	18 (42)
Submucosal injection
Always	5 (12)
Sometimes	21 (49)
Never	17 (39)

EUS: Endoscopic ultrasound.

Table 4 Post-ampullectomy practices

Practice	n(%)
Pancreatic stent
Always	37 (86)
Sometimes	4 (9)
Never	2 (4)
Adjunct therapy1
APC	35 (83)
Multi/monopolar	3 (7)
Nd-Yag	1 (2)
Cold biopsy	3 (7)
Follow-up2
One month	6 (16)
Three months	21 (55)
Six months	11 (29)
One year	0 (0)

¹One respondent who checked both argon plasma coagulation (APC) and multipolar/monopolar electrocoagulation probe is not included here;

²Four respondents who checked 2 follow-up intervals are not included here. They each checked 1 and 6 mo, 3 mo and 1 year, 1 and 3 mo, 3 and 6 mo.