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    
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.
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.
Digestive Disease Center, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon and Seoul, Korea.
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