INTRODUCTION: Compared with traditional radiologic methods for the detection of cholelithiasis, early transient hypertransaminasemia had provided a useful prediction of biliary etiology in patients with acute pancreatitis. AIM: To investigate whether this application remains valid in the modern era of imaging for microlithiasis. METHODOLOGY: The biochemical detection (LFT) of cholelithiasis was based on an increase in serum alanine transaminase of >or=80 IU/L (normal range, 0-45 IU/L) within 24 hours of admission. We have taken the collective findings of abdominal ultrasound (USS), endoscopic ultrasound (EUS), and postmortem examination to represent the denominator for the diagnosis of cholelithiasis against which comparison with LFT was made. RESULTS: Of 68 patients with acute pancreatitis who were treated between October 2000 and December 2001, cholelithiasis was the etiological factor in 44 patients (65%). EUS detected microlithiasis in 5 of 10 patients examined. The etiology remained idiopathic in 3 patients (4.4%). The sensitivity, specificity, and positive and negative predictive values for USS were 86%, 100%, 100%, and 80% respectively; for LFT, they were 91%, 100%, 100%, and 86%; and for USS and LFT combined, they were 98%, 100%, 100%, and 96%, respectively. CONCLUSIONS: In patients with acute pancreatitis, the biochemical analysis within 24 hours of admission provided a simple, rapid, and more accurate prediction of cholelithiasis than USS. The combination of LFT and USS detected or excluded a biliary etiology in almost all patients.
INTRODUCTION: Compared with traditional radiologic methods for the detection of cholelithiasis, early transient hypertransaminasemia had provided a useful prediction of biliary etiology in patients with acute pancreatitis. AIM: To investigate whether this application remains valid in the modern era of imaging for microlithiasis. METHODOLOGY: The biochemical detection (LFT) of cholelithiasis was based on an increase in serum alanine transaminase of >or=80 IU/L (normal range, 0-45 IU/L) within 24 hours of admission. We have taken the collective findings of abdominal ultrasound (USS), endoscopic ultrasound (EUS), and postmortem examination to represent the denominator for the diagnosis of cholelithiasis against which comparison with LFT was made. RESULTS: Of 68 patients with acute pancreatitis who were treated between October 2000 and December 2001, cholelithiasis was the etiological factor in 44 patients (65%). EUS detected microlithiasis in 5 of 10 patients examined. The etiology remained idiopathic in 3 patients (4.4%). The sensitivity, specificity, and positive and negative predictive values for USS were 86%, 100%, 100%, and 80% respectively; for LFT, they were 91%, 100%, 100%, and 86%; and for USS and LFT combined, they were 98%, 100%, 100%, and 96%, respectively. CONCLUSIONS: In patients with acute pancreatitis, the biochemical analysis within 24 hours of admission provided a simple, rapid, and more accurate prediction of cholelithiasis than USS. The combination of LFT and USS detected or excluded a biliary etiology in almost all patients.
Authors: Erwin J M van Geenen; Donald L van der Peet; Pranav Bhagirath; Chris J J Mulder; Marco J Bruno Journal: Nat Rev Gastroenterol Hepatol Date: 2010-08-10 Impact factor: 46.802
Authors: Nicolien J Schepers; Olaf J Bakker; Marc G H Besselink; Thomas L Bollen; Marcel G W Dijkgraaf; Casper H J van Eijck; Paul Fockens; Erwin J M van Geenen; Janneke van Grinsven; Nora D L Hallensleben; Bettina E Hansen; Hjalmar C van Santvoort; Robin Timmer; Marie-Paule G F Anten; Clemens J M Bolwerk; Foke van Delft; Hendrik M van Dullemen; G Willemien Erkelens; Jeanin E van Hooft; Robert Laheij; René W M van der Hulst; Jeroen M Jansen; Frank J G M Kubben; Sjoerd D Kuiken; Lars E Perk; Rogier J J de Ridder; Marno C M Rijk; Tessa E H Römkens; Erik J Schoon; Matthijs P Schwartz; B W Marcel Spanier; Adriaan C I T L Tan; Willem J Thijs; Niels G Venneman; Frank P Vleggaar; Wim van de Vrie; Ben J Witteman; Hein G Gooszen; Marco J Bruno Journal: Trials Date: 2016-01-05 Impact factor: 2.279
Authors: Stefan A Bouwense; Marc G Besselink; Sandra van Brunschot; Olaf J Bakker; Hjalmar C van Santvoort; Nicolien J Schepers; Marja A Boermeester; Thomas L Bollen; Koop Bosscha; Menno A Brink; Marco J Bruno; Esther C Consten; Cornelis H Dejong; Peter van Duijvendijk; Casper H van Eijck; Jos J Gerritsen; Harry van Goor; Joos Heisterkamp; Ignace H de Hingh; Philip M Kruyt; I Quintus Molenaar; Vincent B Nieuwenhuijs; Camiel Rosman; Alexander F Schaapherder; Joris J Scheepers; Marcel B W Spanier; Robin Timmer; Bas L Weusten; Ben J Witteman; Bert van Ramshorst; Hein G Gooszen; Djamila Boerma Journal: Trials Date: 2012-11-26 Impact factor: 2.279