GIE Associate Editor Monique Barakat, MD, highlights this article from the October issue: “Development and validation of the SDLD score: a simplified tool to predict successful endoscopic papillectomy in ampullary lesions” by Kien Vu Trung, MD, et al.

This study provides valuable insights into the predictors of incomplete resection in patients undergoing endoscopic papillectomy for ampullary lesions. The study identifies key variables such as lesion size, dysplasia, lateral spread, and duct dilation and applies these variables to develop the SDLD score to guide decision-making surrounding endoscopic versus surgical resection approach.

In addition, the study emphasizes the importance of a multidisciplinary approach in managing the most complex among these cases, advocating for the essential element of collaboration among health care providers.

This is a good study on a challenging topic. I recommend this article because the comprehensive scoring system it introduces takes into account key predictors of incomplete resection of ampullary lesions. Introduction of the SDLD score offers a valuable tool for clinicians and endoscopists to make informed decisions regarding endoscopic papillectomy versus surgical options, ultimately aiming to improve patient outcomes.

The take-home points are:

• Ampullary adenomas require comprehensive initial evaluations that include laboratory studies, biopsies, and EUS for assessment.
• The study identifies key factors that predict incomplete resection during endoscopic papillectomy, including lesion size, presence of high-grade dysplasia, laterally spreading lesions, and duct dilation.
• These key factors predictive of incomplete resection were used to create an SDLD score to predict likelihood of successful resection.
• This research underscores the necessity of a multidisciplinary approach for managing ampullary lesions.

The area under the receiver-operating characteristic curve of the training and validation sets. AUC, Area under the curve; ROC, receiver-operating characteristic.

Read the full article online.

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