Prospective assessment of the utility of EUS in the evaluation of gallstone pancreatitis

Chak, Amitabh; Hawes, Robert H.; Cooper, Gregory S.; Hoffman, Brenda J.; Catalano, Marc F.; Wong, Richard C.K.; Herbener, Thomas E.; Sivak, Michael

doi:10.1016/s0016-5107(99)70388-3

Cited by 189 publications

(111 citation statements)

References 20 publications

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“…Gallstones can be documented within the common bile duct with accuracy similar to ERCP by EUS (39,205,(207)(208)(209)(210)(211)(212)(213)(214)(215)(216)(217)(218)(219)(220)(221)(222)(223)(224)(225)(226), with somewhat lower accuracy by MRCP (227)(228)(229)(230)(231)(232)(233), and by intraoperative cholangiography at the time of laparoscopic cholecystectomy (234)(235)(236)(237). Identification of a biliary etiology of acute pancreatitis is important because recurrent episodes will occur in one-third to two-thirds of these patients in follow-up periods of as short as 3 months unless gallstones are eliminated (238,239).…”

Section: Treatment Guideline Vii: Role Of Ercp and Biliary Sphincteromentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,615

941

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Section: Treatment Guideline Vii: Role Of Ercp and Biliary Sphincteromentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,615

941

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“…3,5 Its use before ERCP may avoid unnecessary, invasive ERCP procedures, resulting in fewer complications. 6,7 The indications for EUS in ABP are problematic. Patients at high risk of BDS can undergo ERCP directly.…”

Section: Creatitis (Abp) Multidetector Computed Tomography (Mdct)mentioning

confidence: 99%

The Usefulness of Early Endoscopic Ultrasonography in Acute Biliary Pancreatitis with Undetectable Choledocholithiasis on Multidetector Computed Tomography

Park

Kim

Han

et al. 2016

Korean J Gastroenterol

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Background/Aims: EUS can detect bile duct stones (BDS) that are undetectable on multidetector computed tomography (MDCT). BDS associated with acute biliary pancreatitis (ABP) are small and tend to be excreted spontaneously. This study evaluated the usefulness of early EUS in patients with ABP and undetectable BDS on MDCT. Methods: Forty-one patients with ABP and undetectable BDS on MDCT underwent EUS within 24 hours of admission and were diagnosed with BDS, sludge, dilated common bile duct (CBD), or normal CBD. ERCP was performed in patients with BDS, sludge, or clinical deterioration. The diagnostic yield and the effects of early EUS on morbidity, mortality, and the length of hospitalization were evaluated. Results: EUS detected BDS or sludge in 48.8% of patients examined. BDS was the diagnosis in 13 patients, sludge in seven, and neither for 21 patients. ERCP was performed in 20 patients with BDS or sludge, in two patients with coexisting cholangitis, and in one patient with worsening liver function tests. ERCP identified BDS in 12 patients and sludge in seven. No lesions were diagnosed in four patients by ERCP. All patients improved, and the length of hospitalization in patients with ERCP was 9.0 days, without ERCP 7.1 days. Two patients with major complications by ERCP were hospitalized for a prolonged time. Conclusions: Early EUS may be useful to select patients for therapeutic ERCP in cases of suspected ABP with undetectable BDS on MDCT. (Korean J Gastroenterol 2016;68:202-209)

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“…In a prospective and competitive blinded study in patients with CBD obstruction EUS gave 100% accuracy for the diagnosis of choledocholithiasis; it was also significantly more sensitive than transabdominal ultrasonography or CT [10] . In patients with unexplained ARP the use of EUS with high resolution increases the chances of detecting microlithiasis ( Figure 3), a frequent cause of pancreatitis [2,11,12] . A large study by Frossard et al evaluated 168 patients referred with diagnosis of idiopathic pancreatitis.…”

Section: Microlithiasismentioning

confidence: 99%