Tawfik Khoury1,2, Amir Shahin1,2, Wisam Sbeit1,2. 1. Galilee Medical Center, Gastroenterology, Nahariya 2220903, Israel. 2. Azrieli Faculty of Medicine, Bar-Ilan University, Safed 5290002, Israel.
Abstract
BACKGROUND: Patients with acute idiopathic pancreatitis (AIP) should undergo further imaging tests such as endoscopic ultrasound (EUS) for further investigation. The time interval between an episode of AIP and EUS performance is still controversial. AIMS: We aimed to explore the optimal timing for performing EUS and to reveal parameters that might predict longer intervals needed for performing EUS. METHODS: We performed a single-center retrospective study at Galilee Medical Center from January 2015 to January 2020, at which point we included all patients who underwent EUS for further investigation of AIP. RESULTS: Overall, we included 50 patients. The average age of all patients was 54.2 ± 17.6 years (range 22-69 years), and more than half of the study cohort were males (58%). Classifying patients as inflamed vs. normal pancreatic tissue on EUS, we found that among patients with normal pancreatic tissue, EUS was performed 44.7 ± 28.3 days from discharge, while for patients with inflamed pancreatic tissue, it was 48.1 ± 22.3 days (p = 0.37) after discharge. Notably, the CT severity index was significantly associated with inflamed pancreatic tissue on EUS, as it was 2.4 ± 0.74 vs. 1.5 ± 1.3 in the normal pancreatic tissue group (p = 0.03). There were no differences in the Bedside index for severity in acute pancreatitis (BISAP) scores, and there were no differences in the average American Society of Anesthesiologist Physical Status (ASA) scores between the two groups. Notably, 26.3% of patients had inflamed pancreatic tissue when performing EUS at 4 weeks, as compared to 16% who had inflamed pancreatic tissue at EUS performed after 6 weeks. CONCLUSION: Radiological severity score was the only important factor in determining the time interval of performing EUS after an episode of AIP. Intervals greater than six weeks seem to be needed among patients with higher Balthazar scores.
BACKGROUND: Patients with acute idiopathic pancreatitis (AIP) should undergo further imaging tests such as endoscopic ultrasound (EUS) for further investigation. The time interval between an episode of AIP and EUS performance is still controversial. AIMS: We aimed to explore the optimal timing for performing EUS and to reveal parameters that might predict longer intervals needed for performing EUS. METHODS: We performed a single-center retrospective study at Galilee Medical Center from January 2015 to January 2020, at which point we included all patients who underwent EUS for further investigation of AIP. RESULTS: Overall, we included 50 patients. The average age of all patients was 54.2 ± 17.6 years (range 22-69 years), and more than half of the study cohort were males (58%). Classifying patients as inflamed vs. normal pancreatic tissue on EUS, we found that among patients with normal pancreatic tissue, EUS was performed 44.7 ± 28.3 days from discharge, while for patients with inflamed pancreatic tissue, it was 48.1 ± 22.3 days (p = 0.37) after discharge. Notably, the CT severity index was significantly associated with inflamed pancreatic tissue on EUS, as it was 2.4 ± 0.74 vs. 1.5 ± 1.3 in the normal pancreatic tissue group (p = 0.03). There were no differences in the Bedside index for severity in acute pancreatitis (BISAP) scores, and there were no differences in the average American Society of Anesthesiologist Physical Status (ASA) scores between the two groups. Notably, 26.3% of patients had inflamed pancreatic tissue when performing EUS at 4 weeks, as compared to 16% who had inflamed pancreatic tissue at EUS performed after 6 weeks. CONCLUSION: Radiological severity score was the only important factor in determining the time interval of performing EUS after an episode of AIP. Intervals greater than six weeks seem to be needed among patients with higher Balthazar scores.
Authors: Vikesh K Singh; Bechien U Wu; Thomas L Bollen; Kathryn Repas; Rie Maurer; Richard S Johannes; Koenraad J Mortele; Darwin L Conwell; Peter A Banks Journal: Am J Gastroenterol Date: 2009-03-17 Impact factor: 10.864
Authors: Nora D Hallensleben; Devica S Umans; Stefan Aw Bouwense; Robert C Verdonk; Tessa Eh Romkens; Ben J Witteman; Matthijs P Schwartz; Marcel B Spanier; Robert Laheij; Hjalmar C van Santvoort; Marc G Besselink; Jeanin E van Hooft; Marco J Bruno Journal: United European Gastroenterol J Date: 2019-11-14 Impact factor: 4.623