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Article: Detection of choledocholithiasis by EUS in acute pancreatitis: A prospective evaluation in 100 consecutive patients
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TitleDetection of choledocholithiasis by EUS in acute pancreatitis: A prospective evaluation in 100 consecutive patients
 
AuthorsLiu, CL1 1
Lo, CM1
Chan, JKF1
Poon, RTP1
Lam, CM1
Fan, ST1
Wong, J1
 
Issue Date2001
 
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gie
 
CitationGastrointestinal Endoscopy, 2001, v. 54 n. 3, p. 325-330 [How to Cite?]
DOI: http://dx.doi.org/10.1067/mge.2001.117513
 
AbstractBackground: ERCP is the standard for detection of choledocholithiasis in patients with acute biliary pancreatitis, and, if performed early, ERCP decreases morbidity. However, there are procedure-related complications. The aim of the present prospective study was to evaluate the ability of EUS to detect choledocholithiasis in patients presenting with acute pancreatitis. Methods: The study group comprised 100 consecutive patients who presented with acute pancreatitis. EUS, and immediately thereafter, ERCP were performed by separate blinded examiners within 24 hours of admission. The diagnostic accuracy of EUS in identifying gallbladder stones was compared with that of transcutaneous US. The diagnostic accuracy of EUS in detecting choledocholithiasis was then compared with that of US and ERCP based on the results of endoscopic instrumentation of the bile duct after sphincterotomy. Results: EUS was more sensitive than US in detecting gallbladder stones (100% vs. 84%, p < 0.005). The sensitivities of ERCP and EUS for choledocholithiasis were both 97%, and the overall accuracies were 96% and 98%, respectively, with no significant difference. EUS detected the absence of choledocholithiasis in 65 of 66 patients (specificity = 98%). Endosonographic examination was successful in all patients, whereas ERCP was unsuccessful in 5 patients (p > 0.05). Post-endoscopic sphincterotomy bleeding developed in 4 patients; there was no EUS-related morbidity (p > 0.05). Conclusion: EUS is more sensitive than US in detecting biliary stones in patients with acute pancreatitis. It is as accurate as ERCP in detecting choledocholithiasis. EUS can be used to select patients with acute pancreatitis who require therapeutic ERCP, thus avoiding diagnostic ERCP and its associated potential for complications in the majority of patients.
 
ISSN0016-5107
2012 Impact Factor: 5.21
2012 SCImago Journal Rankings: 1.543
 
DOIhttp://dx.doi.org/10.1067/mge.2001.117513
 
ISI Accession Number IDWOS:000170784600008
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLiu, CL
 
dc.contributor.authorLo, CM
 
dc.contributor.authorChan, JKF
 
dc.contributor.authorPoon, RTP
 
dc.contributor.authorLam, CM
 
dc.contributor.authorFan, ST
 
dc.contributor.authorWong, J
 
dc.date.accessioned2010-09-06T08:39:39Z
 
dc.date.available2010-09-06T08:39:39Z
 
dc.date.issued2001
 
dc.description.abstractBackground: ERCP is the standard for detection of choledocholithiasis in patients with acute biliary pancreatitis, and, if performed early, ERCP decreases morbidity. However, there are procedure-related complications. The aim of the present prospective study was to evaluate the ability of EUS to detect choledocholithiasis in patients presenting with acute pancreatitis. Methods: The study group comprised 100 consecutive patients who presented with acute pancreatitis. EUS, and immediately thereafter, ERCP were performed by separate blinded examiners within 24 hours of admission. The diagnostic accuracy of EUS in identifying gallbladder stones was compared with that of transcutaneous US. The diagnostic accuracy of EUS in detecting choledocholithiasis was then compared with that of US and ERCP based on the results of endoscopic instrumentation of the bile duct after sphincterotomy. Results: EUS was more sensitive than US in detecting gallbladder stones (100% vs. 84%, p < 0.005). The sensitivities of ERCP and EUS for choledocholithiasis were both 97%, and the overall accuracies were 96% and 98%, respectively, with no significant difference. EUS detected the absence of choledocholithiasis in 65 of 66 patients (specificity = 98%). Endosonographic examination was successful in all patients, whereas ERCP was unsuccessful in 5 patients (p > 0.05). Post-endoscopic sphincterotomy bleeding developed in 4 patients; there was no EUS-related morbidity (p > 0.05). Conclusion: EUS is more sensitive than US in detecting biliary stones in patients with acute pancreatitis. It is as accurate as ERCP in detecting choledocholithiasis. EUS can be used to select patients with acute pancreatitis who require therapeutic ERCP, thus avoiding diagnostic ERCP and its associated potential for complications in the majority of patients.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationGastrointestinal Endoscopy, 2001, v. 54 n. 3, p. 325-330 [How to Cite?]
DOI: http://dx.doi.org/10.1067/mge.2001.117513
 
dc.identifier.doihttp://dx.doi.org/10.1067/mge.2001.117513
 
dc.identifier.epage330
 
dc.identifier.hkuros89252
 
dc.identifier.isiWOS:000170784600008
 
dc.identifier.issn0016-5107
2012 Impact Factor: 5.21
2012 SCImago Journal Rankings: 1.543
 
dc.identifier.issue3
 
dc.identifier.openurl
 
dc.identifier.pmid11522972
 
dc.identifier.scopuseid_2-s2.0-0035458873
 
dc.identifier.spage325
 
dc.identifier.urihttp://hdl.handle.net/10722/83322
 
dc.identifier.volume54
 
dc.languageeng
 
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gie
 
dc.publisher.placeUnited States
 
dc.relation.ispartofGastrointestinal Endoscopy
 
dc.relation.referencesReferences in Scopus
 
dc.rightsGastrointestinal Endoscopy. Copyright © Mosby, Inc.
 
dc.titleDetection of choledocholithiasis by EUS in acute pancreatitis: A prospective evaluation in 100 consecutive patients
 
dc.typeArticle
 
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<description.abstract>Background: ERCP is the standard for detection of choledocholithiasis in patients with acute biliary pancreatitis, and, if performed early, ERCP decreases morbidity. However, there are procedure-related complications. The aim of the present prospective study was to evaluate the ability of EUS to detect choledocholithiasis in patients presenting with acute pancreatitis. Methods: The study group comprised 100 consecutive patients who presented with acute pancreatitis. EUS, and immediately thereafter, ERCP were performed by separate blinded examiners within 24 hours of admission. The diagnostic accuracy of EUS in identifying gallbladder stones was compared with that of transcutaneous US. The diagnostic accuracy of EUS in detecting choledocholithiasis was then compared with that of US and ERCP based on the results of endoscopic instrumentation of the bile duct after sphincterotomy. Results: EUS was more sensitive than US in detecting gallbladder stones (100% vs. 84%, p &lt; 0.005). The sensitivities of ERCP and EUS for choledocholithiasis were both 97%, and the overall accuracies were 96% and 98%, respectively, with no significant difference. EUS detected the absence of choledocholithiasis in 65 of 66 patients (specificity = 98%). Endosonographic examination was successful in all patients, whereas ERCP was unsuccessful in 5 patients (p &gt; 0.05). Post-endoscopic sphincterotomy bleeding developed in 4 patients; there was no EUS-related morbidity (p &gt; 0.05). Conclusion: EUS is more sensitive than US in detecting biliary stones in patients with acute pancreatitis. It is as accurate as ERCP in detecting choledocholithiasis. EUS can be used to select patients with acute pancreatitis who require therapeutic ERCP, thus avoiding diagnostic ERCP and its associated potential for complications in the majority of patients.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong