Academic Journal
Comparison of Early Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Management of Acute Biliary Pancreatitis: A Prospective Randomized Study
| Title: | Comparison of Early Endoscopic Ultrasonography and Endoscopic Retrograde Cholangiopancreatography in the Management of Acute Biliary Pancreatitis: A Prospective Randomized Study |
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| Authors: | Fan, ST, Wong, J, Wong, BC, Poon, RTP, Lo, CM, Lam, CM, Liu, CL, Tso, WK, Wong, Y |
| Source: | Clinical Gastroenterology and Hepatology. 3:1238-1244 |
| Publisher Information: | Elsevier BV, 2005. |
| Publication Year: | 2005 |
| Subject Terms: | Male, Pancreatitis, Acute Necrotizing - diagnosis - etiology - surgery, Time Factors, Cholangiopancreatography, Endoscopic Retrograde - methods, Endosonography, Cholelithiasis - complications - diagnosis - surgery, 03 medical and health sciences, 0302 clinical medicine, Cholelithiasis, 80 and over, Humans, Endoscopic Retrograde - methods, Prospective Studies, Aged, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Pancreatitis, Acute Necrotizing, Survival Rate - trends, Length of Stay, Middle Aged, Cholangiopancreatography, 3. Good health, Survival Rate, Treatment Outcome, Pancreatitis, Female, Acute Necrotizing - diagnosis - etiology - surgery, Follow-Up Studies |
| Description: | The role and potential benefits of endoscopic ultrasonography (EUS) in the management of acute biliary pancreatitis have not been documented. We report a large prospective randomized study comparing early EUS and endoscopic retrograde cholangiopancreatography (ERCP) in the management of these patients.A prospective randomized study was performed on 140 patients with acute pancreatitis suspected to have a biliary cause. The patients were randomized to have EUS (n = 70) or ERCP (n = 70) within 24 hours from admission. In the EUS group, when EUS detected choledocholithiasis, therapeutic ERCP was performed during the same endoscopy session. In the ERCP group, diagnostic ERCP was performed, followed by therapeutic endoscopy when choledocholithiasis was detected.Examination of the biliary tree by EUS was successful in all patients in the EUS group, whereas cannulation of the common duct during ERCP was unsuccessful in 10 patients (14%) in the ERCP group (P = .001). Combined percutaneous ultrasonography and ERCP missed detection of cholelithiasis in 6 patients in the ERCP group. The overall morbidity rate was 7% in the EUS group, and that in the ERCP group was 14% (P = .172). The hospital stay and mortality rates were comparable in both groups.In selected patients with acute biliary pancreatitis, EUS could safely replace diagnostic ERCP in the management for selecting patients with choledocholithiasis for therapeutic ERCP with a higher successful examination rate, a higher sensitivity in the detection of cholelithiasis, and a comparable morbidity rate. |
| Document Type: | Article |
| Language: | English |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/s1542-3565(05)00619-1 |
| Access URL: | https://pubmed.ncbi.nlm.nih.gov/16361050 http://hub.hku.hk/handle/10722/77502 http://www.sciencedirect.com/science/article/pii/S1542356505006191 https://www.ncbi.nlm.nih.gov/pubmed/16361050 https://www.cghjournal.org/article/S1542-3565(05)00619-1/fulltext https://www.cghjournal.org/article/S1542-3565(05)00619-1/pdf https://pubmed.ncbi.nlm.nih.gov/16361050/ http://hdl.handle.net/10722/77502 |
| Rights: | Elsevier TDM |
| Accession Number: | edsair.doi.dedup.....ec2c3b39f2c58996dd79ece9432cf1ef |
| Database: | OpenAIRE |
| ISSN: | 15423565 |
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| DOI: | 10.1016/s1542-3565(05)00619-1 |