Original Article: Clinical EndoscopyDiagnostic performance of EUS for chronic pancreatitis: a comparison with histopathology
Section snippets
Patients and methods
All patients between 1995 and 2003 with chronic pain and presumed CP undergoing a pancreatic surgery that involved obtaining an intraoperative histologic specimen were identified from the Medical University of South Carolina surgical database. Patients were included in the study if an EUS was performed within 1 year before surgery. Pancreatic malignancies were excluded. All EUS procedures were performed by experienced endosonographers at a single center by using radial echoendoscopes (EU-M20,
Results
A total of 71 patients were eligible, all of whom had clinical features consistent with CP. Thirty-eight were women (54%). The age range of the cohort was 18 to 73 years, with a mean of 45 years. The specimens were obtained from the following procedures: distal pancreatectomy in 19 (27%), lateral pancreaticojejunostomy in 25 (35%), pancreaticoduodenostomy in 26 (37%), and a total pancreatectomy in 1 (1%). In patients with lateral pancreaticojejunostomies, the specimen evaluated by histology
Discussion
This is, to date, the largest study comparing EUS findings with histopathology in CP in human beings. The only other study to do so, published in abstract form, compared EUS findings with histopathology in 6 patients with CP.6 One other study compared intraductal US (IDUS) with ex vivo pancreatic specimens but did not specifically address the correlation between the number of IDUS features and histologic changes in patients with CP.7
The cutoff number of EUS criteria used to diagnose CP has
References (21)
- et al.
Prospective evaluation of endoscopic ultrasonography, endoscopic retrograde pancreatography, and secretin test in the diagnosis of chronic pancreatitis
Gastrointest Endosc
(1998) - et al.
Prospective assessment of the ability of endoscopic ultrasound to diagnose, exclude, or establish the severity of chronic pancreatitis found by endoscopic retrograde cholangiopancreatography
Gastrointest Endosc
(1998) - et al.
Course of alcoholic chronic pancreatitis: a prospective clinicomorphological long-term study
Gastroenterology
(1996) - et al.
The reliability of EUS for the diagnosis of chronic pancreatitis: interobserver agreement among experienced endosonographers
Gastrointest Endosc
(2001) - et al.
Comparison of EUS findings with histopathology in chronic pancreatitis
Gastrointest Endosc
(1997) - et al.
Differential diagnosis of pancreatic diseases with an intraductal ultrasound system
Gastrointest Endosc
(1994) - et al.
EUS in the diagnosis of early chronic pancreatitis: a prospective follow-up study
Gastrointest Endosc
(2002) - et al.
EUS-guided Trucut biopsy of suspected nonfocal chronic pancreatitis
Gastrointest Endosc
(2005) - et al.
A prospective study of pancreatic disease in patients with alcoholic cirrhosis: comparative diagnostic value of ERCP and EUS and long-term significance of isolated parenchymal abnormalities
Gastrointest Endosc
(1999) - et al.
Detection of embryologic ventral pancreatic parenchyma with endoscopic ultrasound
Gastrointest Endosc
(1996)
Cited by (127)
The Gemelli Ultrasound Chronic Pancreatitis Score: A Non-invasive Tool for the Diagnosis of Chronic Pancreatitis
2022, Ultrasound in Medicine and BiologyA new ultrasound score for the assessment and follow-up of chronic pancreatitis: The ‘Gemelli USCP score’
2020, Digestive and Liver DiseaseCitation Excerpt :In the last years, significant improvements in abdominal imaging with computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance colangio-pancreatography (MRCP), endoscopic ultrasonography (EUS), and transabdominal ultrasound (US) allowed more accurate assessments of morphologic changes, including the earlier stages of CP. In the diagnostic workup of CP, EUS seems to have the highest accuracy, with a good agreement with CT, MRI/MRCP [5,6], and ERCP [7,8]. Then, CT scan provides excellent information about morphological changes of the pancreas, such as parenchymal sub-atrophy/atrophy, pancreatic ducts dilatation, calcifications, and the presence of fluid collections and pseudocysts.
Total Pancreatectomy With Islet Autotransplantation
2020, Pediatric Gastrointestinal and Liver Disease, Sixth Edition
See CME section; p. 872.