{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T08:07:49Z","timestamp":1784707669646,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Endoscopic papillectomy (EP) is the gold standard treatment for ampullary adenomas. However, EP is still burdened by a nonnegligible rate of incomplete resections (IR). Different predictors have been linked to higher rates of IR, but the interaction between these factors is still unclear. The aim of the study was to develop a scoring system (hereby called PANETH score) able to quantify the risk of IR after EP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients who underwent EP in 19 Italian centers in 2016\u20132021 were included. IR was defined as the presence of residual tumor in lateral or endoampullary margins after EP. Predictors for IR were analyzed by logistic regression and were used to obtain an easy\u2010to\u2010use numeric score. The performance of the model was evaluated with a receiver operating characteristic curve analysis and tested by means of 10\u2010fold cross\u2010validation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 430 patients were included. On multivariate analysis, laterally spreading tumor (odds ratio [OR] 5.81, 3.21\u20137.65; <jats:italic>P<\/jats:italic>\u2009=\u20090.02), intraductal extension (OR 6.92, 3.33\u20139.87; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), and bile duct dilation (OR 2.61, 1.22\u20134.32; <jats:italic>P<\/jats:italic>\u2009=\u20090.004) were significant predictors of IR. The score was calculated by the sum of regression coefficients of\u00a0each predictor. A\u2009\u22653 score indicated a 4\u2010fold risk of IR\u00a0(<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001). The internal validation resulted in an area\u00a0under the curve of 0.83 and an overall error rate of 0.11.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The proposed PANETH score may represent a\u00a0reliable and easily applicable tool to predict the risk of\u00a0IR\u00a0after EP to optimize patient selection and risk stratification.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.15005","type":"journal-article","created":{"date-parts":[[2025,3,23]],"date-time":"2025-03-23T06:11:23Z","timestamp":1742710283000},"page":"749-757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Development and validation of a risk score for incomplete resection during endoscopic papillectomy: PANETH score"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1148-9684","authenticated-orcid":false,"given":"Cecilia","family":"Binda","sequence":"first","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec\u2010Cesena Hospitals AUSL Romagna  Forl\u00ec\u2010Cesena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Facciorusso","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Experimental Medicine Universit\u00e0 del Salento  Lecce Italy"},{"name":"Clinical Effectiveness Research Group University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2125-7588","authenticated-orcid":false,"given":"Stefano","family":"Fabbri","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec\u2010Cesena Hospitals AUSL Romagna  Forl\u00ec\u2010Cesena 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Gastroenterology and Digestive Endoscopy, Department of Gastroenterology Humanitas Research Hospital \u2013 IRCCS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romano","family":"Sassatelli","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, AUSL di Reggio Emilia Arcispedale Santa Maria Nuova  Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armando","family":"Gabbrielli","sequence":"additional","affiliation":[{"name":"Center for Medical Sciences (CISMed) University of Trento  Trento Italy"},{"name":"Multizonal Unit of Gastoenterology and Digestive Endoscopy APSS Trento  Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo Giorgio","family":"Arcidiacono","sequence":"additional","affiliation":[{"name":"Pancreato\u2010Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS Vita Salute San Raffaele University  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco Maria","family":"Di Matteo","sequence":"additional","affiliation":[{"name":"Therapeutic Digestive Endoscopy Policlinico Universitario Campus Bio\u2010Medico  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Coluccio","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, Forl\u00ec\u2010Cesena Hospitals AUSL Romagna  Forl\u00ec\u2010Cesena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit Infermi Hospital, AUSL Romagna  Rimini Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano","family":"Spada","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"},{"name":"Gastroenterology and Digestive Endoscopy Unit Fondazione Poliambulanza Istituto Ospedaliero  Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Fantin","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Istituto Oncologico Veneto Istituto di Ricovero e Cura a Carattere Scientifico  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"De Angelis","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Unit Azienda Ospedaliero Universitaria Citt\u00e0 della Salute e della Scienza di Torino  Torino Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Macchiarelli","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit Azienda Ospedaliera Universitaria Senese  Siena 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