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Article: Comparison of early endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in the management of acute biliary pancreatitis: A prospective randomized study

TitleComparison of early endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in the management of acute biliary pancreatitis: A prospective randomized study
Authors
Issue Date2005
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/cgh
Citation
Clinical Gastroenterology And Hepatology, 2005, v. 3 n. 12, p. 1238-1244 How to Cite?
AbstractBackground & Aims: The role and potential benefits of endoscopic ultrasonography (EUS) in the management of acute biliary pancreatitis have not been documented. We report a large prospective randomized study comparing early EUS and endoscopic retrograde cholangiopancreatography (ERCP) in the management of these patients. Methods: A prospective randomized study was performed on 140 patients with acute pancreatitis suspected to have a biliary cause. The patients were randomized to have EUS (n = 70) or ERCP (n = 70) within 24 hours from admission. In the EUS group, when EUS detected choledocholithiasis, therapeutic ERCP was performed during the same endoscopy session. In the ERCP group, diagnostic ERCP was performed, followed by therapeutic endoscopy when choledocholithiasis was detected. Results: Examination of the biliary tree by EUS was successful in all patients in the EUS group, whereas cannulation of the common duct during ERCP was unsuccessful in 10 patients (14%) in the ERCP group (P = .001). Combined percutaneous ultrasonography and ERCP missed detection of cholelithiasis in 6 patients in the ERCP group. The overall morbidity rate was 7% in the EUS group, and that in the ERCP group was 14% (P = .172). The hospital stay and mortality rates were comparable in both groups. Conclusions: In selected patients with acute biliary pancreatitis, EUS could safely replace diagnostic ERCP in the management for selecting patients with choledocholithiasis for therapeutic ERCP with a higher successful examination rate, a higher sensitivity in the detection of cholelithiasis, and a comparable morbidity rate. © 2005 by the American Gastroenterological Association.
Persistent Identifierhttp://hdl.handle.net/10722/77502
ISSN
2015 Impact Factor: 7.68
2015 SCImago Journal Rankings: 2.744
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorTso, WKen_HK
dc.contributor.authorWong, Yen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorWong, BCen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T07:32:35Z-
dc.date.available2010-09-06T07:32:35Z-
dc.date.issued2005en_HK
dc.identifier.citationClinical Gastroenterology And Hepatology, 2005, v. 3 n. 12, p. 1238-1244en_HK
dc.identifier.issn1542-3565en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77502-
dc.description.abstractBackground & Aims: The role and potential benefits of endoscopic ultrasonography (EUS) in the management of acute biliary pancreatitis have not been documented. We report a large prospective randomized study comparing early EUS and endoscopic retrograde cholangiopancreatography (ERCP) in the management of these patients. Methods: A prospective randomized study was performed on 140 patients with acute pancreatitis suspected to have a biliary cause. The patients were randomized to have EUS (n = 70) or ERCP (n = 70) within 24 hours from admission. In the EUS group, when EUS detected choledocholithiasis, therapeutic ERCP was performed during the same endoscopy session. In the ERCP group, diagnostic ERCP was performed, followed by therapeutic endoscopy when choledocholithiasis was detected. Results: Examination of the biliary tree by EUS was successful in all patients in the EUS group, whereas cannulation of the common duct during ERCP was unsuccessful in 10 patients (14%) in the ERCP group (P = .001). Combined percutaneous ultrasonography and ERCP missed detection of cholelithiasis in 6 patients in the ERCP group. The overall morbidity rate was 7% in the EUS group, and that in the ERCP group was 14% (P = .172). The hospital stay and mortality rates were comparable in both groups. Conclusions: In selected patients with acute biliary pancreatitis, EUS could safely replace diagnostic ERCP in the management for selecting patients with choledocholithiasis for therapeutic ERCP with a higher successful examination rate, a higher sensitivity in the detection of cholelithiasis, and a comparable morbidity rate. © 2005 by the American Gastroenterological Association.en_HK
dc.languageengen_HK
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/cghen_HK
dc.relation.ispartofClinical Gastroenterology and Hepatologyen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshCholangiopancreatography, Endoscopic Retrograde - methodsen_HK
dc.subject.meshCholelithiasis - complications - diagnosis - surgeryen_HK
dc.subject.meshEndosonographyen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHumansen_HK
dc.subject.meshLength of Stayen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshPancreatitis, Acute Necrotizing - diagnosis - etiology - surgeryen_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshSurvival Rate - trendsen_HK
dc.subject.meshTime Factorsen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleComparison of early endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in the management of acute biliary pancreatitis: A prospective randomized studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1542-3565&volume=3&issue=12&spage=1238&epage=1244&date=2005&atitle=Comparison+of+early+endoscopic+ultrasonography+and+endoscopic+retrograde+cholangiopancreatography+in+the+management+of+acute+biliary+pancreatitis:+a+prospective+randomized+studyen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hku.hken_HK
dc.identifier.emailWong, BC: bcywong@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityWong, BC=rp00429en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S1542-3565(05)00619-1en_HK
dc.identifier.pmid16361050-
dc.identifier.scopuseid_2-s2.0-29144439904en_HK
dc.identifier.hkuros116495en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-29144439904&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume3en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1238en_HK
dc.identifier.epage1244en_HK
dc.identifier.isiWOS:000234236200015-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridTso, WK=7006905486en_HK
dc.identifier.scopusauthoridWong, Y=7403041884en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridLam, CM=36799183200en_HK
dc.identifier.scopusauthoridWong, BC=7402023340en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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