Endoscopic ultrasound as a diagnostic and predictive tool in idiopathic acute pancreatitis

Valverde-López, Francisco; Ortega-Suazo, Eva Julissa; Wilcox, C. Mel; Fernandez-Cano, Maria Carmen; Martínez-Cara, Juan Gabriel; Redondo–Cerezo, Eduardo

doi:10.20524/aog.2020.0464

Cited by 7 publications

(7 citation statements)

References 34 publications

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“…After the selection by title, abstract, and full-text, 119 were eligible for qualitative synthesis and quantitative synthesis. Of these, 119 studies were used for proportion calculations, and 29 2 , 22 – 49 studies detailed the mean follow-up time that could be used for IR calculations. Details of the selection process are shown in Figure 2 .…”

Section: Resultsmentioning

confidence: 99%

Incidence of recurrent and chronic pancreatitis after acute pancreatitis: a systematic review and meta-analysis

Gagyi,

Teutsch,

Veres

et al. 2024

Therap Adv Gastroenterol

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Background: Acute pancreatitis (AP) has a high incidence, and patients can develop recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) after AP. Objectives: We aimed to estimate the pooled incidence rates (IRs), cumulative incidences, and proportions of RAP and CP after AP. Design: A systematic review and meta-analysis of studies reporting the proportion of RAP and CP after AP. Data sources and methods: The systematic search was conducted in three (PubMed, EMBASE, and CENTRAL) databases on 19 December 2023. Articles reporting the proportion of RAP or CP in patients after the first and multiple episodes of AP were eligible. The random effects model was used to calculate the pooled IR with 95% confidence intervals (CIs). The I2 value assessed heterogeneity. The risk of bias assessment was conducted with the Joanna Briggs Institute Critical Appraisal Tool. Results: We included 119 articles in the quantitative synthesis and 29 in the IRs calculations. Our results showed that the IR of RAP in adult patients after AP was 5.26 per 100 person-years (CI: 3.99–6.94; I2 = 93%), while in children, it was 4.64 per 100 person-years (CI: 2.73–7.87; I2 = 88%). We also found that the IR of CP after AP was 1.4 per 100 person-years (CI: 0.9–2; I2 = 75%), while after RAP, it increased to 4.3 per 100 person-years (CI: 3.1–6.0; I2 = 76%). The risk of bias was moderate in the majority of the included studies. Conclusion: Our results showed that RAP affects many patients with AP. Compared to patients with the first AP episode, RAP leads to a threefold higher IR for developing CP. Trial registration: Our protocol was registered on PROSPERO (CRD42021283252).

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Section: Resultsmentioning

confidence: 99%

Incidence of recurrent and chronic pancreatitis after acute pancreatitis: a systematic review and meta-analysis

Gagyi,

Teutsch,

Veres

et al. 2024

Therap Adv Gastroenterol

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“…Although there is a lower rate of diagnosis of biliary disease in patients without a gallbladder, lithiasis is still the second most common EUS finding in IARP after chronic pancreatitis. Sphincter of Oddi dysfunction and pancreas divisum have been associated with high recurrence rates in other studies of IARP [48][49][50][51][52].…”

Section: Role Of Eus In Biliary Pancreatitismentioning

confidence: 86%

Endoscopic Ultrasound to Identify the Actual Cause of Idiopathic Acute Pancreatitis: A Systematic Review

Cammarata,

Rovati,

Fontana

et al. 2023

Diagnostics

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Idiopathic acute pancreatitis (IAP) presents a diagnostic challenge and refers to cases where the cause of acute pancreatitis remains uncertain despite a comprehensive diagnostic evaluation. Endoscopic ultrasound (EUS) has emerged as a valuable tool in the diagnostic workup of IAP. This review explores the pivotal role of EUS in detecting the actual cause of IAP and assessing its accuracy, timing, safety, and future technological improvement. In this review, we investigate the role of EUS in identifying the actual cause of IAP by examining the available literature. We aim to assess possible existing evidence regarding EUS accuracy, timing, and safety and explore potential trends of future technological improvements in EUS for diagnostic purposes. Following PRISMA guidelines, 60 pertinent studies were selected and analysed. EUS emerges as a crucial diagnostic tool, particularly when conventional imaging fails. It can offer intricate visualization of the pancreas, biliary system, and adjacent structures. Microlithiasis, biliary sludge, chronic pancreatitis, and small pancreatic tumors seem to be much more accurately identified with EUS in the setting of IAP. The optimal timing for EUS is post-resolution of the acute phase of the disease. With a low rate of complications, EUS poses minimal safety concerns. EUS-guided interventions, including fine-needle aspiration, collection drainage, and biopsies, aid in the cytological analysis. With high diagnostic accuracy, safety, and therapeutic potential, EUS is able to improve patient outcomes when managing IAP. Further refinement of EUS techniques and cost-effectiveness assessment of EUS-guided approaches need to be explored in multicentre prospective studies. This review underscores EUS as a transformative tool in unraveling IAP’s enigma and advancing diagnostic and therapeutic strategies.

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“…Although there is lower rate of diagnosis of biliary disease in patients without gallbladder, lithiasis is still the second most common EUS finding in IARP after chronic pancreatitis. Sphincter of Oddi dysfunction and pancreas divisum have been associated with high recurrence rates in other studies of IARP [48][49][50][51][52].…”

Section: Role Of Eus In Idiopathic Acute Recurrent Pancreatitis Pancr...mentioning

confidence: 86%

Endoscopic Ultrasound to Identify the Actual Cause of Idiopathic Acute Pancreatitis: A Comprehensive Review

Cammarata,

Rovati,

Fontana

et al. 2023

Preprint

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Idiopathic acute pancreatitis (IAP) presents a diagnostic challenge and refers to cases where the cause of acute pancreatitis remains uncertain despite a comprehensive diagnostic evalua-tion. Endoscopic ultrasound (EUS) has emerged as a valuable tool in the diagnostic workup of IAP. This review explores the pivotal role of EUS in detecting the actual cause of IAP, as-sessing its accuracy, timing, safety, and future technological improvement. Following PRISMA guidelines, 60 pertinent studies were selected and analysed. EUS emerges as a cru-cial diagnostic tool, particularly when conventional imaging fails. It can offer intricate visu-alization of the pancreas, biliary system, and adjacent structures. High accuracy of EUS is evident in detecting the actual causes of IAP such as microlithiasis, small bile duct stones, pancreas divisum, and small pancreatic tumors. Optimal timing for EUS is post-resolution of the acute phase of the disease. EUS, when conducted by experienced endoscopists, it boasts minimal safety concerns, and is crucial to prevent complications. EUS-guided interventions, including fine-needle aspiration, collection drainage, and biopsies, aid in cytological analy-sis. With high diagnostic accuracy, safety, and therapeutic potential, EUS is able to improve patient outcomes when managing IAP. Further refinement of EUS techniques and cost-effectiveness assessment of EUS-guided approaches need to be explored in multicenter prospective studies. This review underscores EUS as a transformative tool in unraveling IAP's enigma and advancing diagnostic and therapeutic strategies.

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Endoscopic ultrasound as a diagnostic and predictive tool in idiopathic acute pancreatitis

Cited by 7 publications

References 34 publications

Incidence of recurrent and chronic pancreatitis after acute pancreatitis: a systematic review and meta-analysis

Incidence of recurrent and chronic pancreatitis after acute pancreatitis: a systematic review and meta-analysis

Endoscopic Ultrasound to Identify the Actual Cause of Idiopathic Acute Pancreatitis: A Systematic Review

Endoscopic Ultrasound to Identify the Actual Cause of Idiopathic Acute Pancreatitis: A Comprehensive Review

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