Document Detail


The role of intraductal US in the management of idiopathic recurrent pancreatitis without a definite cause on ERCP.
MedLine Citation:
PMID:  21316049     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The cause of pancreatitis is unknown in as many as 30% of cases of recurrent acute pancreatitis, even after ERCP. OBJECTIVE: To investigate the role of intraductal US (IDUS) for managing idiopathic recurrent pancreatitis (IRP). DESIGN: Prospective study. SETTING: Tertiary referral hospital. PATIENTS: Thirty-one patients with suspicious IRP with negative findings on ERCP. INTERVENTIONS: IDUS during ERCP. MAIN OUTCOME MEASUREMENTS: IDUS findings showing any possible cause of pancreatitis. RESULTS: IDUS revealed small bile duct stones (≤3 mm) in 5 patients (16.1%) and sludge in 3 patients (9.7%). The detection rate for a bile duct stone and sludge was significantly higher in patients with a dilated CBD than a nondilated CBD on ERCP (71.4 vs 12.5%; P < .05). Recurrent pancreatitis did not develop in 7 of 8 patients with biliary stones or sludge after an endoscopic sphincterotomy (EST). Two patients (6.5%) demonstrated a small polypoid lesion on the distal end of the pancreatic duct. One patient underwent surgery for intra-ampullary cancer, and another one underwent EST without another attack of pancreatitis. Three patients (9.7%) showed evidence of chronic pancreatitis with small pancreatic stones and/or calcifications on IDUS. LIMITATIONS: Small number of patients. IDUS results were not compared with those of conventional EUS. There was no reference standard for chronic pancreatitis as diagnosed by IDUS. CONCLUSIONS: IDUS identified a possible cause of idiopathic recurrent pancreatitis in 42% of patients with negative findings on ERCP. The IDUS-guided approach combined with ERCP and EST may be useful for decreasing recurring attacks of pancreatitis.
Authors:
Hyun Su Kim; Jong Ho Moon; Hyun Jong Choi; Jong Chan Lee; Seung Hyo Han; Su Jin Hong; Tae Hoon Lee; Young Koog Cheon; Young Deok Cho; Sang-Heum Park; Moon Sung Lee
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-10
Journal Detail:
Title:  Gastrointestinal endoscopy     Volume:  -     ISSN:  1097-6779     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0010505     Medline TA:  Gastrointest Endosc     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.
Affiliation:
Digestive Disease Center, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon and Seoul, Korea.
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