{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T13:57:35Z","timestamp":1754488655863},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"07","license":[{"start":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T00:00:00Z","timestamp":1530662400000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002The anatomical meaning of the terms \u201cproximal\u201d and \u201cdistal\u201d in relation to the pancreaticobiliary anatomy can be confusing. We aimed to investigate practice patterns of use of the terms \u201cproximal\u201d and \u201cdistal\u201d for pancreaticobiliary anatomy amongst various medical specialties. <\/jats:p><jats:p>\n          Materials and methods\u2002An online survey link to a normal pancreaticobiliary diagram was emailed to a multispecialty physician pool. Respondents were asked to label various parts of the common bile duct (CBD) and pancreatic duct (PD) using the terms \u201cproximal,\u201d \u201cdistal,\u201d \u201cnot sure,\u201d or \u201cother.\u201d Variability in use of these terms between specialties was assessed. <\/jats:p><jats:p>\n          Results\u2002We received 370 completed surveys from 182 gastroenterologists (49.2\u200a%), 97 surgeons (26.2\u200a%), 68 radiologists (18.4\u200a%), and 23 other physicians (6.2\u200a%). There was overall consensus in describing the upper\/sub-hepatic CBD as \u201cproximal CBD\u201d (73.8\u200a%, P\u200a=\u200a0.1499) and the lower\/pre-ampullary portion as \u201cdistal CBD\u201d (84.6\u200a%, P\u200a=\u200a0.1821).<\/jats:p><jats:p>However, there was marked variability when describing the PD. The PD in the head of the pancreas was labeled as \u201cproximal PD\u201d by 42.4\u200a% and \u201cdistal PD\u201d also by 42.4\u200a% (P\u200a&lt;\u200a0.0001); and in the tail as \u201cproximal PD\u201d by 41.4\u200a% and \u201cdistal PD\u201d by 43.2\u200a% (P\u200a&lt;\u200a0.0001). Only 13.8\u200a% of respondents used descriptive terminology (\u201cPD in the head\u201d or \u201cPD in the tail\u201d) for the PD. Radiologists most often used descriptive terminology for both the CBD and PD. Surgeons most consistently called \u201cproximal PD\u201d in the head, and \u201cdistal PD\u201d in the tail of the pancreas.<\/jats:p><jats:p>\n          Conclusions\u2002Although use of the terms \u201cproximal\u201d and \u201cdistal\u201d is still very common to describe pancreaticobiliary anatomy, there is a discordance about its meaning, particularly for the PD. Use of descriptive terminology may be a more accurate alternative to prior ambiguous terminologies such as \u201cproximal\u201d or \u201cdistal\u201d and can serve to improve communication and decrease the possibility of medical errors.<\/jats:p>","DOI":"10.1055\/a-0605-3331","type":"journal-article","created":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T22:52:17Z","timestamp":1530744737000},"page":"E801-E805","source":"Crossref","is-referenced-by-count":3,"title":["Heads or tails: confusion about \u201cproximal\u201d and \u201cdistal\u201d terminology for pancreaticobiliary anatomy"],"prefix":"10.1055","volume":"06","author":[{"given":"Harshit","family":"Khara","sequence":"additional","affiliation":[{"name":"Center for Advanced Therapeutic Endoscopy, Department of Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Truptesh","family":"Kothari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amitpal","family":"Johal","sequence":"additional","affiliation":[{"name":"Center for Advanced Therapeutic Endoscopy, Department of Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shivangi","family":"Kothari","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Center for Advanced Therapeutic Endoscopy, Department of Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashok","family":"Bhanushali","sequence":"additional","affiliation":[{"name":"Department of Vascular and Interventional Radiology, Geisinger Medical Center, Danville, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anil","family":"Kotru","sequence":"additional","affiliation":[{"name":"Department of Surgery, Geisinger Medical Center, Danville, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Translational Informatics, Geisinger Health System, Danville, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Kaul","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seth","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, NYU Langone Medical Center, New York, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"DiMaio","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Hale","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Norwalk Hospital Gastroenterology Consultants, Norwalk, Connecticut, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rami","family":"Abbass","sequence":"additional","affiliation":[{"name":"Digestive Health Institute, University Hospitals, Cleveland, Ohio, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marvin","family":"Ryou","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Brigham & Women's Hospital, Boston, Massachusetts United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrita","family":"Sethi","sequence":"additional","affiliation":[{"name":"Division of Digestive and Liver Diseases, Department of Medicine, Columbia University Medical Center, New York, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Turner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Weill Cornell Medical College, Cornell University, New York, New York, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Fockens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Diehl","sequence":"additional","affiliation":[{"name":"Center for Advanced Therapeutic Endoscopy, Department of Gastroenterology, Geisinger Medical Center, Danville, Pennsylvania, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2018,7,4]]},"container-title":["Endoscopy International Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-0605-3331.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,6]],"date-time":"2019-05-06T20:43:15Z","timestamp":1557175395000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-0605-3331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7]]},"references-count":0,"journal-issue":{"issue":"07","published-online":{"date-parts":[[2018,7,4]]},"published-print":{"date-parts":[[2018,7]]}},"URL":"https:\/\/doi.org\/10.1055\/a-0605-3331","relation":{},"ISSN":["2364-3722","2196-9736"],"issn-type":[{"value":"2364-3722","type":"print"},{"value":"2196-9736","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7]]}}}