November 12, 2014
Notes: Yoon, Hwan
Won, Sung Hyun
Park, Do Hyun
Lee, Sang Soo
Seo, Dong Wan
Lee, Sung Koo
Korean J Gastroenterol. 2013 Jun;61(6):327-32.
Author Address: Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Reference Type: Journal Article
Record Number: 5087Author: Yoon, L. Y., Moon, J. H., Choi, H. J., Kim, D. C., Seo, J. Y., Lee, T. H., Cha, S. W., Cho, Y. D., Park, S. H. and Kim, S. J.
Title: Clinical usefulness of intraductal ultrasonography for the management of acute biliary pancreatitis
Journal: J Gastroenterol Hepatol
Date: Jul 22
Short Title: Clinical usefulness of intraductal ultrasonography for the management of acute biliary pancreatitis
Alternate Journal: Journal of gastroenterology and hepatology
ISSN: 1440-1746 (Electronic)
Accession Number: 23869951
Abstract: BACKGROUND AND AIM: Identifying a bile duct (BD) stone in patients with acute biliary pancreatitis (ABP) is important for the management and prevention of recurrent attack of pancreatitis. However, small BD stones may not be detected on ERCP. The aim of this study was to prospectively evaluate the usefulness of intraductal ultrasonography (IDUS) in patients suspected to have ABP but with no evidence of choledocholithiasis on ERCP. METHODS: A total 92 patients suspected with ABP without evidence of BD stones on imaging studies including ERCP were enrolled. Wire guided IDUS was performed during ERCP in all patients. Stones or sludge detected by IDUS were confirmed after endoscopic sphincterotomy (EST) and extraction. If IDUS finding was negative, then we swept the BD with a balloon catheter and/or basket without EST. After endoscopic management, comparison between IDUS and endoscopic finding was carried out to determine the diagnostic accuracy of IDUS. RESULTS: Among the 92 patients, IDUS revealed BD stones in 33 (35.9%). All 33 patients’ stones were confirmed by endoscopic visualization after EST and BD exploration. During the mean follow-up of 24 months, recurrent pancreatitis did not occur in 90 of 92 patients (97.9%) with ABP after endoscopic treatment according to the IDUS findings. CONCLUSIONS: IDUS improves diagnostic accuracy for the detection of clinically occult BD stones in patients suspicious ABP. IDUS guided endoscopic management for patients with ABP can avoid unnecessary EST and help prevent recurrent pancreatitis.