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• W2317165737 abstract "Background. Acute pancreatitis, a common severe disease, remains as an important cause of high morbidity, mortality and costs. Gallstones are by far the main etiologic agents for the disease in our country. The gold standard to identify common bile duct stones in biliary pancreatitis currently is made by endoscopic retrograde cholangiopancreatography (ERCP), an invasive procedure without a 100% of accuracy and with known morbidity and mortality. The main objective of this study was to prospectively evaluate the ability of endosonography (EUS) to identify choledocholithiasis and to assess severity of pancreatic involvement. Methods. The study was conducted at the Clinica Reina Sofía a tertiary care center. The inclusion criteria were patients older than 18 years of age with acute pancreatitis having EUS, abdominal C-T Scan and ERCP when indicated. EUS was performed independently or before the ERCP to every patient included in the study and within 72 hours of admission by the same examiner. The outcome variable was defined as the presence of choledocholithiasis assessed by EUS or by ERCP. Pancreatic involvement findings were correlated with length of hospital stay and compared with the dynamic C-T Scan. Results. Seventy-four patients were prospectively studied during three years. 51 patients had both EUS and ERCP; Normal in 4 (7.8%) vs.12 (23.5%); microlithiasis in 21 (41.2%) vs. 8 (15.7%); biliar sludge in 8 (15.7%) vs. 15 (29.4%); and choledocholithiasis in 18 (35.3%) vs. 16 (31.4%), chi square 12.08, p < 0.01. Length of hospital stay was longer in patients with peripancreatic fluid compared with normal pancreatic imaging by EUS. 69 patients were evaluated for pancreatic involvement comparing EUS and dynamic C-T Scan: Normal 20 (29%) vs. 32 (46.4%); edema 34 (49%) vs. 26 (37.7%); one peripancreatic fluid collection 15 (21.7%) vs. 8 (11.6%); and distant fluid collections in 0 vs. 3 (4.3%), chi square 8.97, p 0.03. Conclusions. EUS could reliably identify cholelithiasis and is more sensitive than ERCP in detecting choledocholithiasis due to microlithiasis. These results support the use of EUS to select those who would truly benefit from drainage and stone extraction procedures. This study showed that EUS was able to detect changes of the pancreatic tissue earlier than dynamic C-T Scan. EUS detected small peripancreatic fluid collections that were not apparent by CT scan, but its real utility on this aspect should be evaluated by further research. Background. Acute pancreatitis, a common severe disease, remains as an important cause of high morbidity, mortality and costs. Gallstones are by far the main etiologic agents for the disease in our country. The gold standard to identify common bile duct stones in biliary pancreatitis currently is made by endoscopic retrograde cholangiopancreatography (ERCP), an invasive procedure without a 100% of accuracy and with known morbidity and mortality. The main objective of this study was to prospectively evaluate the ability of endosonography (EUS) to identify choledocholithiasis and to assess severity of pancreatic involvement. Methods. The study was conducted at the Clinica Reina Sofía a tertiary care center. The inclusion criteria were patients older than 18 years of age with acute pancreatitis having EUS, abdominal C-T Scan and ERCP when indicated. EUS was performed independently or before the ERCP to every patient included in the study and within 72 hours of admission by the same examiner. The outcome variable was defined as the presence of choledocholithiasis assessed by EUS or by ERCP. Pancreatic involvement findings were correlated with length of hospital stay and compared with the dynamic C-T Scan. Results. Seventy-four patients were prospectively studied during three years. 51 patients had both EUS and ERCP; Normal in 4 (7.8%) vs.12 (23.5%); microlithiasis in 21 (41.2%) vs. 8 (15.7%); biliar sludge in 8 (15.7%) vs. 15 (29.4%); and choledocholithiasis in 18 (35.3%) vs. 16 (31.4%), chi square 12.08, p < 0.01. Length of hospital stay was longer in patients with peripancreatic fluid compared with normal pancreatic imaging by EUS. 69 patients were evaluated for pancreatic involvement comparing EUS and dynamic C-T Scan: Normal 20 (29%) vs. 32 (46.4%); edema 34 (49%) vs. 26 (37.7%); one peripancreatic fluid collection 15 (21.7%) vs. 8 (11.6%); and distant fluid collections in 0 vs. 3 (4.3%), chi square 8.97, p 0.03. Conclusions. EUS could reliably identify cholelithiasis and is more sensitive than ERCP in detecting choledocholithiasis due to microlithiasis. These results support the use of EUS to select those who would truly benefit from drainage and stone extraction procedures. This study showed that EUS was able to detect changes of the pancreatic tissue earlier than dynamic C-T Scan. EUS detected small peripancreatic fluid collections that were not apparent by CT scan, but its real utility on this aspect should be evaluated by further research." @default.
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• W2317165737 title "7019 A prospective evaluation of endoscopic ultrasonography reliability for choledocholithiasis and pancreatic involvement diagnosis in acute pancreatitis." @default.
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