Expert teams will tackle two of the most controversial topics in hepatology and GI endoscopy during Monday’s AASLD Academic Debates session, providing attendees with a unique opportunity to hear both sides of the hot-button issues.

Kimberly Ann Brown, MD, FAASLD

Kimberly Ann Brown, MD, FAASLD

John Vargo, MD, MPH, FASGE

John Vargo, MD, MPH, FASGE

“What makes this interesting is that, while we’ve had pro-con debates before, these will be team debates,” said ASGE Secretary John Vargo, MD, MPH, FASGE, who is co-chair of the session with AASLD Secretary Kimberly Ann Brown, MD, FAASLD. “I think that adds a little more flavor to it.”

According to Dr. Brown, the team debate approach has been successful at AASLD’s The Liver Meeting®. The concept was adapted for DDW®, where two of the meeting’s sponsoring societies — AASLD and ASGE — will choose the controversial topics.

Each society selected a topic and expert teams of pro and con debaters consisting of fellows and a senior member of the society. After each team presents its arguments, a distinguished panel of judges will determine the winning team.

“The idea is to pick topics and teams that will be very interesting and create a lively debate,” said Dr. Brown, chief of the division of gastroenterology and hepatology at Henry Ford Health System, Detroit, MI. “The goal is to make it both exciting and educational for the audience.”

The AASLD debaters will address the question, “Anticoagulation for Portal Vein Thrombosis in Advanced Cirrhotics: Pro or Con?” The senior members of the teams are Guadalupe Garcia-Tsao, MD, FAASLD, speaking on the pro side, and John Lake, MD, FAASLD, who is presenting the rebuttal.

“This is a very controversial topic,” Dr. Brown said. “The current guidelines suggest against anticoagulating these patients, but more and more evidence is emerging that it may be beneficial in select patients. Trying to identify which patients we should be anticoagulating and how we might be changing the guidelines moving forward will be a really good debate.”

Dr. Vargo’s ASGE teams will debate the question, “Endoscopic Submucosal Dissection (ESD) for Laterally Spreading Granular Tumors of Colon: Pro or Con?” The pro team rebuttal will be presented by Peter V. Draganov, MD, AGAF, FACG, and the con rebuttal by Douglas K. Rex, FACP, AGAF, FACG, FASGE.

“Traditionally, we have been removing colonic polyps in a piecemeal fashion by endoscopic mucosal resections (EMR),” said Dr. Vargo, chair of the department of gastroenterology and hepatology at the Cleveland Clinic, Ohio. “With larger polyps comes the potential risk for cancer, and one of the ideas that is being discussed is whether endoscopists should be addressing larger polyps of the colon with ESD instead of EMR.”

From a pathology standpoint, ESD makes sense because the single-piece removal allows pathologists to more easily assess the lateral and deep margins for malignancy, Dr. Vargo noted.

“In the debate, we’ll be trying to look at this in an evidence-based fashion to answer some important questions,” he said. “What is the state of the art with ESD in the colon? Is it ready for primetime in this clinical setting, or should we just keep this technique for the esophagus and stomach?”

The co-chairs agree that the debates will not only be lively and informative for the audience, but they will also provide an added benefit for the participating fellows, giving them a platform alongside their mentors to learn and hone their presentation skills.

“Attendees get to hear outstanding state-of-the-art presentations and the GI fellows get a unique educational experience that they will really enjoy,” Dr. Vargo said.
Please refer to the DDW Mobile App or the Program section in Monday’s DDW Daily News for additional details on this and other DDW events.