Radionuclide biliary scanning in acute pancreatitis

Glazer, G; Murphy, Frank G.; Clayden, Gerald S.; Lawrence, Rosemary G.; Craig, Oscar

doi:10.1002/bjs.1800681105

Cited by 24 publications

(7 citation statements)

References 16 publications

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“…A modification of this system was suggested by Imrie et a18 (Table 1) and has been used widely in the United KingdomW l" while some have preferred diagnostic peritoneal lavage for prognostic purposes. 10 This study reappraises the discriminatory value of individual factors determined within 48 hours of admission, assesses the ability of the scoring Eight of the factors considered showed significant differences between the severe and mild outcome groups (Table 3). Each of these eight factors was useful in selecting patients at increased risk of severe disease using the defined cut points (Table 4).…”

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confidence: 99%

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Prognostic factors in acute pancreatitis.

Blamey¹,

Imrie²,

O’Neill³

et al. 1984

Gut

635

295

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SUMMARY Prognostic factor scoring systems provide one method of predicting severity of acute pancreatitis. This paper reports the prospective assessment of a system using nine factors available within 48 hours of admission. This assessment does not include patient data used to compile the system. Of 405 episodes of acute pancreatitis occurring in a seven year period, 72% had severity correctly predicted by the system; 31% of 131 episodes with three or more factors present were severe and 8% of 274 episodes with less than three factors were severe. Assessment of individual factors revealed only one which did not predict severity. A scoring system based on the other eight factors correctly predicted severity in 79% of episodes. Prognostic factor scoring systems (i) alert the clinician to potentially severe disease, (ii) allow comparison of severity within and between patient series and (iii) will allow rational selection of patients for trials of new treatment.

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confidence: 99%

“…diagnostic peritoneal lavage for prognostic purposes. 10 This study reappraises the discriminatory value of individual factors determined within 48 hours of admission, assesses the ability of the scoring system of Imrie et at8 to define patients with severe disease, and evaluates modifications to simplify the system but improve its accuracy. …”

mentioning

confidence: 99%

Prognostic factors in acute pancreatitis.

Blamey¹,

Imrie²,

O’Neill³

et al. 1984

Gut

635

295

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“…Unfortunately, this impressive result was not substantiated in two subse quent studies which reported accuracies of only 38% [8] and 53% [20]. However, the scanning time in these stud ies has varied between 1 h [22] and 6 h [20] with a posi tive test being defined as an absent GB image. Serafini et al [21], in a study of 60 patients with acute pancreatitis, recorded images up to 24 h and classified scans into 5 groups on the basis of the rate of uptake of isotope by the GB and its excretion into the duodenum.…”

Section: Discussionmentioning

confidence: 93%

“…Glazer et al [22] first reported the use of biliary scan ning in acute pancreatitis and diagnosed gallstone pancre atitis with an accuracy of 100%. Unfortunately, this impressive result was not substantiated in two subse quent studies which reported accuracies of only 38% [8] and 53% [20].…”

Section: Discussionmentioning

confidence: 99%

Radionuclide Biliary Scanning in the Diagnosis of Gallstone Pancreatitis

Downing¹,

Timmins²,

Watkins³

et al. 1985

Dig Surg

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The ability of hepatobiliary scanning (^99mTc HID A) to distinguish gallstone (GS) from non-gallstone (NGS) pancreatitis was investigated in 29 patients. 4 patients had repeat scans during a recurrent attack (33 scans in 29 patients). 15 patients (17 scans) had GS – in 13 scans the gallbladder was not visualized (sensitivity = 76.5%) compared to 2 of the 16 scans in patients with NGS (specificity = 87.5%). The duodenum was not visualized in 2 (11.8%) and 4 (25%) scans in the GS and NGS groups, respectively. Isotope appeared in the duodenum at 25.7 ± 9.2 min (mean ± SD) in the GS group and 33.3 ± 10.5 in the NSG group (p < 0.02). Hepatobiliary scanning provides a dynamic study of bile excretion in acute pancreatitis, but cannot be used alone to confidently diagnose the presence of gallstones.

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“…A modification of this system was sug gested by Imrie et al [49], which found a positive response in centers with a predominance of AP of biliary etiology [50,51 ]. Many slight modifications of these scor ing systems have been published afterwards with the intention of optimizing their usefulness [52][53][54].…”

Section: Scoring Systemsmentioning

confidence: 99%

Diagnosis and Staging of Acute Pancreatitis

Malfertheiner¹,

Domínguez‐Muñoz²

1994

Dig Surg

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Determination of serum pancreatic enzymes remains the gold standard for the diagnosis of acute pancreatitis. Clinical symptoms and signs are of major importance in suspecting the disease, but they are not accurate enough to confirm the diagnosis. The different serum pancreatic enzymes have a similar accuracy in the diagnosis of acute pancreatitis. Total amylase, pancreatic isoamylase and lipase are preferred, since simple, rapid and inexpensive enzymatic methods are commercially available. More expensive and cumbersome methods (e.g. RIA or ELISA for pancreatic elastase) are useful only in special clinical circumstances. For early etiological classification of acute pancreatitis serum pancreatic enzymes and even different enzyme ratios are not reliable. For this purpose, determination of AST, bilirubin and alkaline phosphatase may make it possible to distinguish between biliary and nonbiliary origin of the disease. Ultrasonography and computed tomography provide very valuable information regarding not only etiology but also local complications of acute pancreatitis. Once the diagnosis of acute pancreatitis has been established, prognostic classification of the disease is required for adequate monitoring and treatment. Clinical symptoms and signs do not allow early assessment of the prognosis of acute pancreatitis. Multivariate scoring systems are sensitive but not sufficiently specific for the identification of severe pancreatitis. Among several biochemical markers commercially available for the assessment of severity, C-reactive protein and PMN-elastase appear to be the most valuable. These markers allow a proper selection of patients who need further investigation by contrast-enhanced CT (the gold standard for detection of pancreatic necrosis).

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Radionuclide biliary scanning in acute pancreatitis

Cited by 24 publications

References 16 publications

Prognostic factors in acute pancreatitis.

Prognostic factors in acute pancreatitis.

Radionuclide Biliary Scanning in the Diagnosis of Gallstone Pancreatitis

Diagnosis and Staging of Acute Pancreatitis

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