Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Dig Liver Dis. 2023 Jan;55(1):29-39. doi: 10.1016/j.dld.2022.08.021. Epub 2022 Sep 10.
Enteroscopy plays an important role in the management of small bowel bleeding. However, current guidelines are not specifically designed for small bowel bleeding and recommendations from different international societies do not always align. Consequently, there is heterogeneity in the definitions of clinical entities, clinical practice policies, and adherence to guidelines among clinicians. This represents an obstacle to providing the best patient care and to obtain homogeneous data for clinical research.
The aims of the study were to establish a consensus on the definitions of bleeding entities and on the role of enteroscopy in the management of small bowel bleeding using a Delphi process.
A core group of eight experts in enteroscopy identified five main topics of small bowel bleeding management and drafted statements on each topic. An expert panel of nine gastroenterologists participated in three rounds of the Delphi process, together with the core group.
A total of 33 statements were approved after three rounds of Delphi voting.
This Delphi consensus proposes clear definitions and a unifying strategy to standardize the management of small bowel bleeding. Furthermore, it provides a useful guide in daily practice for both clinical and technical issues of enteroscopy.
小肠镜在小肠出血的管理中起着重要作用。然而，目前的指南并非专门针对小肠出血制定，不同国际协会的建议并不总是一致。因此，临床医生在临床实体的定义、临床实践政策以及对指南的遵循方面存在异质性。这是为患者提供最佳治疗和获得同质临床研究数据的障碍。
本研究旨在通过 Delphi 流程就出血实体的定义以及小肠镜在小肠出血管理中的作用达成共识。
一个由 8 名小肠镜专家组成的核心小组确定了小肠出血管理的五个主要主题，并就每个主题起草了声明。一个由 9 名胃肠病学家组成的专家小组与核心小组一起参加了三轮 Delphi 流程。
三轮 Delphi 投票后，共有 33 项声明获得通过。
这项 Delphi 共识提出了明确的定义和统一的策略，以规范小肠出血的管理。此外，它为临床和技术问题提供了有用的指南，有助于日常实践中的小肠镜操作。
