Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound
OBJECTIVESTo determine prospectively the sensitivity and specificity of endoscopic ultrasound (EUS) for detecting common bile duct stones (CBS) in patients with acute biliary pancreatitis in whom transabdominal ultrasound was negative for CBS. METHODSIn 38 consecutive patients with acute biliary pan...
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| Veröffentlicht in: | European journal of gastroenterology & hepatology 2008-12, Vol.20 (12), p.1171-1175 |
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| container_title | European journal of gastroenterology & hepatology |
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| creator | Štabuc, Borut Drobne, David Ferkolj, Ivan Gruden, Andrej Jereb, Janez Kolar, Gorazd Mlinarič, Vladimir Mervic, Manfred Repše, Aljaž Štepec, Srečko Markovič, Saša |
| description | OBJECTIVESTo determine prospectively the sensitivity and specificity of endoscopic ultrasound (EUS) for detecting common bile duct stones (CBS) in patients with acute biliary pancreatitis in whom transabdominal ultrasound was negative for CBS.
METHODSIn 38 consecutive patients with acute biliary pancreatitis who were negative for CBS by transabdominal ultrasound, EUS was performed before endoscopic retrograde cholangiopancreatography (ERCP). The endoscopist performing ERCP was blind to the results of EUS. The primary goal of EUS and ERCP was to confirm or exclude CBS. The reference standard for CBS was endoscopic extraction of bile duct stones after endoscopic sphincterotomy. When both procedures, EUS and ERCP excluded CBS, it was assumed that there were no CBS and endoscopic sphincterotomy was not performed. The results EUS and ERCP were compared with the McNemar test.
RESULTSTwenty-five of the 38 patients (66%) had CBS. EUS and ERCP were false negative in one patient each, EUS was false positive in two patients and ERCP in one patient. The sensitivity of both EUS and ERCP was 96%. The specificity of EUS and ERCP was 85 and 92%, respectively. The difference between EUS and ERCP was not significant (P=0.9).
CONCLUSIONEUS proved to be as sensitive as ERCP for detection of CBS in patients with acute biliary pancreatitis. Therefore, EUS could be used as the first-line procedure in patients with acute biliary pancreatitis when therapeutic ERCP is not needed. By this approach a substantial number of unnecessary diagnostic ERCP procedures could be avoided. |
| doi_str_mv | 10.1097/MEG.0b013e32830a9a31 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69758724</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69758724</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3807-c85f66e8947b9916e2e522c03737e0c95ec9412527508124e1a05f2e3df5270b3</originalsourceid><addsrcrecordid>eNpdkF1rFTEQhoMo9lj9ByK50butk69N4l0ptQoVbxQEL0I2O8uJ7m6OSZZD_70pPVjwIkwyPDPhfQh5zeCCgdXvv1zfXMAATKDgRoC3XrAnZMekFp3qjX5KdmCV7HrLfpyRF6X8AmBaMP2cnDFjjWWS7cjPy7BVpEOco8939ODXkNHXWGP5QEesGGpMK00TDWlZ2q2RSMctVFpqWrHQY6x7iuuYSkiHGOg21-xL2tbxJXk2-bngq1M9J98_Xn-7-tTdfr35fHV52wVhQHfBqKnv0VipB2tZjxwV5wGEFhohWIXBSsYV1woM4xKZBzVxFOPUejCIc_LuYe8hpz8bluqWWALOs18xbcX1ViujuWygfABDTqVknNwhx6XldgzcvVTXpLr_pbaxN6f927Dg-Dh0stiAtyfAl-DnKTeLsfzjOBiQxtrH_49prpjL73k7YnZ79HPdOwCQvGXuONznbM-uHdDiL1-8kEE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69758724</pqid></control><display><type>article</type><title>Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound</title><source>MEDLINE</source><source>Journals@Ovid Ovid Autoload</source><creator>Štabuc, Borut ; Drobne, David ; Ferkolj, Ivan ; Gruden, Andrej ; Jereb, Janez ; Kolar, Gorazd ; Mlinarič, Vladimir ; Mervic, Manfred ; Repše, Aljaž ; Štepec, Srečko ; Markovič, Saša</creator><creatorcontrib>Štabuc, Borut ; Drobne, David ; Ferkolj, Ivan ; Gruden, Andrej ; Jereb, Janez ; Kolar, Gorazd ; Mlinarič, Vladimir ; Mervic, Manfred ; Repše, Aljaž ; Štepec, Srečko ; Markovič, Saša</creatorcontrib><description>OBJECTIVESTo determine prospectively the sensitivity and specificity of endoscopic ultrasound (EUS) for detecting common bile duct stones (CBS) in patients with acute biliary pancreatitis in whom transabdominal ultrasound was negative for CBS.
METHODSIn 38 consecutive patients with acute biliary pancreatitis who were negative for CBS by transabdominal ultrasound, EUS was performed before endoscopic retrograde cholangiopancreatography (ERCP). The endoscopist performing ERCP was blind to the results of EUS. The primary goal of EUS and ERCP was to confirm or exclude CBS. The reference standard for CBS was endoscopic extraction of bile duct stones after endoscopic sphincterotomy. When both procedures, EUS and ERCP excluded CBS, it was assumed that there were no CBS and endoscopic sphincterotomy was not performed. The results EUS and ERCP were compared with the McNemar test.
RESULTSTwenty-five of the 38 patients (66%) had CBS. EUS and ERCP were false negative in one patient each, EUS was false positive in two patients and ERCP in one patient. The sensitivity of both EUS and ERCP was 96%. The specificity of EUS and ERCP was 85 and 92%, respectively. The difference between EUS and ERCP was not significant (P=0.9).
CONCLUSIONEUS proved to be as sensitive as ERCP for detection of CBS in patients with acute biliary pancreatitis. Therefore, EUS could be used as the first-line procedure in patients with acute biliary pancreatitis when therapeutic ERCP is not needed. By this approach a substantial number of unnecessary diagnostic ERCP procedures could be avoided.</description><identifier>ISSN: 0954-691X</identifier><identifier>EISSN: 1473-5687</identifier><identifier>DOI: 10.1097/MEG.0b013e32830a9a31</identifier><identifier>PMID: 18989141</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins, Inc</publisher><subject>Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnostic Errors ; Digestive system ; Endosonography - methods ; Gallstones - complications ; Gallstones - diagnostic imaging ; Gastroenterology. Liver. Pancreas. Abdomen ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Medical sciences ; Middle Aged ; Other diseases. Semiology ; Pancreatitis - etiology ; Prospective Studies ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Sensitivity and Specificity</subject><ispartof>European journal of gastroenterology & hepatology, 2008-12, Vol.20 (12), p.1171-1175</ispartof><rights>2008 Lippincott Williams & Wilkins, Inc.</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3807-c85f66e8947b9916e2e522c03737e0c95ec9412527508124e1a05f2e3df5270b3</citedby><cites>FETCH-LOGICAL-c3807-c85f66e8947b9916e2e522c03737e0c95ec9412527508124e1a05f2e3df5270b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20804899$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18989141$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Štabuc, Borut</creatorcontrib><creatorcontrib>Drobne, David</creatorcontrib><creatorcontrib>Ferkolj, Ivan</creatorcontrib><creatorcontrib>Gruden, Andrej</creatorcontrib><creatorcontrib>Jereb, Janez</creatorcontrib><creatorcontrib>Kolar, Gorazd</creatorcontrib><creatorcontrib>Mlinarič, Vladimir</creatorcontrib><creatorcontrib>Mervic, Manfred</creatorcontrib><creatorcontrib>Repše, Aljaž</creatorcontrib><creatorcontrib>Štepec, Srečko</creatorcontrib><creatorcontrib>Markovič, Saša</creatorcontrib><title>Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound</title><title>European journal of gastroenterology & hepatology</title><addtitle>Eur J Gastroenterol Hepatol</addtitle><description>OBJECTIVESTo determine prospectively the sensitivity and specificity of endoscopic ultrasound (EUS) for detecting common bile duct stones (CBS) in patients with acute biliary pancreatitis in whom transabdominal ultrasound was negative for CBS.
METHODSIn 38 consecutive patients with acute biliary pancreatitis who were negative for CBS by transabdominal ultrasound, EUS was performed before endoscopic retrograde cholangiopancreatography (ERCP). The endoscopist performing ERCP was blind to the results of EUS. The primary goal of EUS and ERCP was to confirm or exclude CBS. The reference standard for CBS was endoscopic extraction of bile duct stones after endoscopic sphincterotomy. When both procedures, EUS and ERCP excluded CBS, it was assumed that there were no CBS and endoscopic sphincterotomy was not performed. The results EUS and ERCP were compared with the McNemar test.
RESULTSTwenty-five of the 38 patients (66%) had CBS. EUS and ERCP were false negative in one patient each, EUS was false positive in two patients and ERCP in one patient. The sensitivity of both EUS and ERCP was 96%. The specificity of EUS and ERCP was 85 and 92%, respectively. The difference between EUS and ERCP was not significant (P=0.9).
CONCLUSIONEUS proved to be as sensitive as ERCP for detection of CBS in patients with acute biliary pancreatitis. Therefore, EUS could be used as the first-line procedure in patients with acute biliary pancreatitis when therapeutic ERCP is not needed. By this approach a substantial number of unnecessary diagnostic ERCP procedures could be avoided.</description><subject>Acute Disease</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cholangiopancreatography, Endoscopic Retrograde</subject><subject>Diagnostic Errors</subject><subject>Digestive system</subject><subject>Endosonography - methods</subject><subject>Gallstones - complications</subject><subject>Gallstones - diagnostic imaging</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Pancreatitis - etiology</subject><subject>Prospective Studies</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Sensitivity and Specificity</subject><issn>0954-691X</issn><issn>1473-5687</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkF1rFTEQhoMo9lj9ByK50butk69N4l0ptQoVbxQEL0I2O8uJ7m6OSZZD_70pPVjwIkwyPDPhfQh5zeCCgdXvv1zfXMAATKDgRoC3XrAnZMekFp3qjX5KdmCV7HrLfpyRF6X8AmBaMP2cnDFjjWWS7cjPy7BVpEOco8939ODXkNHXWGP5QEesGGpMK00TDWlZ2q2RSMctVFpqWrHQY6x7iuuYSkiHGOg21-xL2tbxJXk2-bngq1M9J98_Xn-7-tTdfr35fHV52wVhQHfBqKnv0VipB2tZjxwV5wGEFhohWIXBSsYV1woM4xKZBzVxFOPUejCIc_LuYe8hpz8bluqWWALOs18xbcX1ViujuWygfABDTqVknNwhx6XldgzcvVTXpLr_pbaxN6f927Dg-Dh0stiAtyfAl-DnKTeLsfzjOBiQxtrH_49prpjL73k7YnZ79HPdOwCQvGXuONznbM-uHdDiL1-8kEE</recordid><startdate>200812</startdate><enddate>200812</enddate><creator>Štabuc, Borut</creator><creator>Drobne, David</creator><creator>Ferkolj, Ivan</creator><creator>Gruden, Andrej</creator><creator>Jereb, Janez</creator><creator>Kolar, Gorazd</creator><creator>Mlinarič, Vladimir</creator><creator>Mervic, Manfred</creator><creator>Repše, Aljaž</creator><creator>Štepec, Srečko</creator><creator>Markovič, Saša</creator><general>Lippincott Williams & Wilkins, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200812</creationdate><title>Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound</title><author>Štabuc, Borut ; Drobne, David ; Ferkolj, Ivan ; Gruden, Andrej ; Jereb, Janez ; Kolar, Gorazd ; Mlinarič, Vladimir ; Mervic, Manfred ; Repše, Aljaž ; Štepec, Srečko ; Markovič, Saša</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3807-c85f66e8947b9916e2e522c03737e0c95ec9412527508124e1a05f2e3df5270b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Acute Disease</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cholangiopancreatography, Endoscopic Retrograde</topic><topic>Diagnostic Errors</topic><topic>Digestive system</topic><topic>Endosonography - methods</topic><topic>Gallstones - complications</topic><topic>Gallstones - diagnostic imaging</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Pancreatitis - etiology</topic><topic>Prospective Studies</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Štabuc, Borut</creatorcontrib><creatorcontrib>Drobne, David</creatorcontrib><creatorcontrib>Ferkolj, Ivan</creatorcontrib><creatorcontrib>Gruden, Andrej</creatorcontrib><creatorcontrib>Jereb, Janez</creatorcontrib><creatorcontrib>Kolar, Gorazd</creatorcontrib><creatorcontrib>Mlinarič, Vladimir</creatorcontrib><creatorcontrib>Mervic, Manfred</creatorcontrib><creatorcontrib>Repše, Aljaž</creatorcontrib><creatorcontrib>Štepec, Srečko</creatorcontrib><creatorcontrib>Markovič, Saša</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of gastroenterology & hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Štabuc, Borut</au><au>Drobne, David</au><au>Ferkolj, Ivan</au><au>Gruden, Andrej</au><au>Jereb, Janez</au><au>Kolar, Gorazd</au><au>Mlinarič, Vladimir</au><au>Mervic, Manfred</au><au>Repše, Aljaž</au><au>Štepec, Srečko</au><au>Markovič, Saša</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound</atitle><jtitle>European journal of gastroenterology & hepatology</jtitle><addtitle>Eur J Gastroenterol Hepatol</addtitle><date>2008-12</date><risdate>2008</risdate><volume>20</volume><issue>12</issue><spage>1171</spage><epage>1175</epage><pages>1171-1175</pages><issn>0954-691X</issn><eissn>1473-5687</eissn><abstract>OBJECTIVESTo determine prospectively the sensitivity and specificity of endoscopic ultrasound (EUS) for detecting common bile duct stones (CBS) in patients with acute biliary pancreatitis in whom transabdominal ultrasound was negative for CBS.
METHODSIn 38 consecutive patients with acute biliary pancreatitis who were negative for CBS by transabdominal ultrasound, EUS was performed before endoscopic retrograde cholangiopancreatography (ERCP). The endoscopist performing ERCP was blind to the results of EUS. The primary goal of EUS and ERCP was to confirm or exclude CBS. The reference standard for CBS was endoscopic extraction of bile duct stones after endoscopic sphincterotomy. When both procedures, EUS and ERCP excluded CBS, it was assumed that there were no CBS and endoscopic sphincterotomy was not performed. The results EUS and ERCP were compared with the McNemar test.
RESULTSTwenty-five of the 38 patients (66%) had CBS. EUS and ERCP were false negative in one patient each, EUS was false positive in two patients and ERCP in one patient. The sensitivity of both EUS and ERCP was 96%. The specificity of EUS and ERCP was 85 and 92%, respectively. The difference between EUS and ERCP was not significant (P=0.9).
CONCLUSIONEUS proved to be as sensitive as ERCP for detection of CBS in patients with acute biliary pancreatitis. Therefore, EUS could be used as the first-line procedure in patients with acute biliary pancreatitis when therapeutic ERCP is not needed. By this approach a substantial number of unnecessary diagnostic ERCP procedures could be avoided.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins, Inc</pub><pmid>18989141</pmid><doi>10.1097/MEG.0b013e32830a9a31</doi><tpages>5</tpages></addata></record> |
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| ispartof | European journal of gastroenterology & hepatology, 2008-12, Vol.20 (12), p.1171-1175 |
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| subjects | Acute Disease Adult Aged Aged, 80 and over Biological and medical sciences Cholangiopancreatography, Endoscopic Retrograde Diagnostic Errors Digestive system Endosonography - methods Gallstones - complications Gallstones - diagnostic imaging Gastroenterology. Liver. Pancreas. Abdomen Humans Investigative techniques, diagnostic techniques (general aspects) Liver. Biliary tract. Portal circulation. Exocrine pancreas Medical sciences Middle Aged Other diseases. Semiology Pancreatitis - etiology Prospective Studies Radiodiagnosis. Nmr imagery. Nmr spectrometry Sensitivity and Specificity |
| title | Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound |
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