Not just a BLiP: early experience with a novel multidisciplinary case conference for benign hepatopancreatobiliary disease at a tertiary Canadian healthcare center.

Benign hepatobiliary disease ERCP EUS Multidisciplinary case conference Pancreatitis Therapeutic endoscopy

Journal

Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653

Informations de publication

Date de publication:
03 Sep 2024
Historique:
received: 30 03 2024
accepted: 17 08 2024
medline: 3 9 2024
pubmed: 3 9 2024
entrez: 3 9 2024
Statut: aheadofprint

Résumé

Benign Liver and Pancreas (BLiPs) rounds, implemented in 2022 at our Canadian tertiary care center, are a novel concept of a multidisciplinary case conference (MCC) for discussion of benign hepatopancreatobiliary (HPB) disease. BLiPs Rounds are a monthly virtual meeting of surgeons, gastroenterologists, and interventional radiologists experienced in biliary and pancreatic disease. This case series was completed to review the patient cases discussed over the first year of BLiPs rounds, and to evaluate the effect of the multidisciplinary discussion on patient management plans. Meeting minutes were reviewed for BLiPs rounds between May 2022 and July 2023. Data were collected retrospectively on all discussed patients by review of the electronic medical record, and analyzed using frequencies and means with standard deviations. Between May 2022 and July 2023, 56 cases were discussed at 12 case conferences. 68% of cases concerned pancreatic pathology, 25% concerned biliary pathology, the remainder liver or duodenal pathology. 49 cases (88%) were presented to discuss therapeutic options, and 7 presented as diagnostic challenges. Cases were usually presented once, but 7 patients were discussed at multiple conferences due to complex issues or ongoing symptomatology. 40 patients (71%) had undergone previous endoscopic, percutaneous, or surgical interventions prior to discussion. Endoscopic intervention was recommended in 32% of cases, percutaneous interventional approach in 13%, a combined endoscopic and percutaneous approach in 9%, and surgery in 18%. Repeat imaging or observation was recommended in 29% of cases. Discussion at rounds led to a change or adjustment in the proposed management in 46 cases (82%). The plan recommended by the MCC was carried out in 71% of cases. BLiPs case conference provides a valuable venue to discuss cases, encourage interdisciplinary collaboration, and refine treatment approaches, leading to a change in proposed management plan in over three-quarters of cases presented.

Sections du résumé

BACKGROUND BACKGROUND
Benign Liver and Pancreas (BLiPs) rounds, implemented in 2022 at our Canadian tertiary care center, are a novel concept of a multidisciplinary case conference (MCC) for discussion of benign hepatopancreatobiliary (HPB) disease. BLiPs Rounds are a monthly virtual meeting of surgeons, gastroenterologists, and interventional radiologists experienced in biliary and pancreatic disease.
METHODS METHODS
This case series was completed to review the patient cases discussed over the first year of BLiPs rounds, and to evaluate the effect of the multidisciplinary discussion on patient management plans. Meeting minutes were reviewed for BLiPs rounds between May 2022 and July 2023. Data were collected retrospectively on all discussed patients by review of the electronic medical record, and analyzed using frequencies and means with standard deviations.
RESULTS RESULTS
Between May 2022 and July 2023, 56 cases were discussed at 12 case conferences. 68% of cases concerned pancreatic pathology, 25% concerned biliary pathology, the remainder liver or duodenal pathology. 49 cases (88%) were presented to discuss therapeutic options, and 7 presented as diagnostic challenges. Cases were usually presented once, but 7 patients were discussed at multiple conferences due to complex issues or ongoing symptomatology. 40 patients (71%) had undergone previous endoscopic, percutaneous, or surgical interventions prior to discussion. Endoscopic intervention was recommended in 32% of cases, percutaneous interventional approach in 13%, a combined endoscopic and percutaneous approach in 9%, and surgery in 18%. Repeat imaging or observation was recommended in 29% of cases. Discussion at rounds led to a change or adjustment in the proposed management in 46 cases (82%). The plan recommended by the MCC was carried out in 71% of cases.
CONCLUSION CONCLUSIONS
BLiPs case conference provides a valuable venue to discuss cases, encourage interdisciplinary collaboration, and refine treatment approaches, leading to a change in proposed management plan in over three-quarters of cases presented.

Identifiants

DOI: 10.1007/s00464-024-11196-w PMID: 39225794
pubmed: 39225794
doi: 10.1007/s00464-024-11196-w
pii: 10.1007/s00464-024-11196-w
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Sydney Selznick (S)

Division of General Surgery, Western University, London, ON, Canada.
CSTAR (Canadian Surgical Technologies & Advanced Robotics), London Health Sciences Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada.
Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada.
ORCID: 0009-0007-7448-0923

Nicholas Mitrou (N)

Division of General Surgery, Western University, London, ON, Canada.
CSTAR (Canadian Surgical Technologies & Advanced Robotics), London Health Sciences Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada.
Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada.

David Peck (D)

Department of Medical Imaging, Western University, London, ON, Canada.

David Hocking (D)

Department of Medical Imaging, Western University, London, ON, Canada.

Michael Sey (M)

Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada.
Division of Gastroenterology, Western University, London, ON, Canada.

Brian M Yan (BM)

Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada.
Division of Gastroenterology, Western University, London, ON, Canada.

Ephraim Tang (E)

Division of General Surgery, Western University, London, ON, Canada.
CSTAR (Canadian Surgical Technologies & Advanced Robotics), London Health Sciences Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada.
Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada.

Ken Leslie (K)

Division of General Surgery, Western University, London, ON, Canada.
CSTAR (Canadian Surgical Technologies & Advanced Robotics), London Health Sciences Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada.
Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada.

Jeff Hawel (J)

Division of General Surgery, Western University, London, ON, Canada. jeff.hawel@lhsc.on.ca.
CSTAR (Canadian Surgical Technologies & Advanced Robotics), London Health Sciences Centre, 339 Windermere Rd, London, ON, N6A 5A5, Canada. jeff.hawel@lhsc.on.ca.
Lawson Health Research Institute, London Health Sciences Centre, London, ON, Canada. jeff.hawel@lhsc.on.ca.

Classifications MeSH