Prospective assessment of the ability of endoscopic ultrasound to diagnose, exclude, or establish the severity of chronic pancreatitis found by endoscopic retrograde cholangiopancreatography☆,☆☆,★,★★
Section snippets
Patients and Methods
Our digestive disease center is a tertiary referral center for pancreatic and biliary disease, with expertise in sphincter of Oddi manometry and EUS. From February 1996 to March 1997, patients referred for ERCP for unexplained abdominal pain and/or suspected CP routinely underwent EUS before ERCP. The following information was collected: age, gender, body mass index (BMI), and presence or absence of alcohol abuse (defined as more than 10 drinks per week).
EUS was performed by experienced
Results
One hundred twenty-six patients underwent both EUS and ERCP. Patient characteristics, final ERCP-based diagnoses, and the frequency of EUS criteria for CP are shown in Table 2.
Empty Cell Cambridge class 0 n = 20 (15.5) 1 n = 10 (7.9) 2 n = 37 (29.4) 3 n = 32 (25.4) 4 n = 27 (21.4) Total n = 126 (100) Demographics Mean age (yr) 48.4 40.9 44.1 47.3 49.5 47.1 Male sex 6 (27.2) 4 (40.0) 13 (35.1) 15 (46.9) 17 (63.0) 55
Discussion
To determine the ability of EUS to accurately diagnose and establish the severity of CP, the use of an appropriate “gold standard” is crucial. Unfortunately, it is impractical to obtain pancreatic biopsy specimens safely, and there is no well-established histologic classification scheme for CP. Although some argue that secretin-stimulated duodenal bicarbonate secretion is the true gold standard for CP (in the absence of pathology),5 others may argue that it is difficult to standardize and
Acknowledgements
We thank Patrick Mauldin, PhD, for carrying out the univariate and multivariate analyses.
References (22)
- et al.
Endoscopic sphincterotomy complications and their management: an attempt at consensus
Gastrointest Endosc
(1991) Indications, contraindications, and complications of endoscopic ultrasonography
Gastrointest Endosc
(1996)- et al.
Diagnosis and grading of chronic pancreatitis by morphological criteria derived by ultrasound and pancreatography
Clin Radiol
(1988) Ultrasound imaging of pancreas and biliary tract
Lancet
(1990)- et al.
Comparison of EUS findings with histopathology in chronic pancreatitis [abstract]
Gastrointest Endosc
(1997) - et al.
Detection of embryological ventral pancreatic parenchyma with endoscopic ultrasound
Gastrointest Endosc
(1996) - et al.
Pancreatography in chronic pancreatitis: international definitions
Gut
(1984) - et al.
ERCP and endoscopic sphincterotomy-induced pancreatitis
Pancreas
(1991) - et al.
Endoscopic management of recurrent and chronic pancreatitis
Scand J Gastroenterol
(1995) Medical management of chronic pancreatitis
Scand J Gastroenterol
(1995)
Stenting in severe chronic pancreatitis: results of medium-term follow-up in 76 patients
Endoscopy
Cited by (0)
- ☆
From the Digestive Disease Center, Medical University of South Carolina, Charleston, South Carolina
- ☆☆
Dr. Sahai was funded by an ASGE/Olympus Advanced Endoscopic Training Scholarship from July 1996 to June 1997 and is currently funded by an ADHF Outcomes Training Award July 1997.
- ★
Reprint requests: Anand Sahai, MD, FRCP, Digestive Disease Center, MUSC, Suite 421, North Tower, 171 Ashley Ave., Charleston, SC 29425-2220.
- ★★
37/1/89900