Imaging tests for accurate diagnosis of acute biliary pancreatitis
Imaging tests for accurate diagnosis of acute biliary pancreatitis作者机构：1st Clinic of Surgery University of Medicine and Pharmacy of Craiova Research Center of Gastroenterology and Hepatology University of Medicine and Pharmacy of Craiova Department of Radiology University of Medicine and Pharmacy of Craiova
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2014年第20卷第44期
页 面：16544-16549页
核心收录：
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
主 题：Biliary Pancreatitis Lithiasis Endoscopic ultrasonography Magnetic resonance cholangiopancreatography Endoscopic retrograde cholangiopancreatography
摘 要：Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis(ABP) is of outmost importance because clearance of lithiasis [gallbladder and common bile duct(CBD)] rules out recurrences. Confirmation of biliary lithiasis is done by imaging. The sensitivity of the ultrasonography(US) in the detection of gallstones is over 95% in uncomplicated cases, but in ABP, sensitivity for gallstone detection is lower, being less than 80% due to the ileus and bowel distension. Sensitivity of transabdominal ultrasonography(TUS) for choledocolithiasis varies between 50%-80%, but the specificity is high, reaching 95%. Diameter of the bile duct may be orientative for diagnosis. Endoscopic ultrasonography(EUS) seems to be a more effectivetool to diagnose ABP rather than endoscopic retrograde cholangiopancreatography(ERCP),which should be performed only for therapeutic *** the sensitivity and specificity of computerized tomography are lower as compared to state-of-the-art magnetic resonance cholangiopancreatography(MRCP)or EUS,especially for small stones and small diameter of CBD,the later techniques are nowadays preferred for the evaluation of ABP *** has the highest accuracy for the diagnosis of choledocholithiasis and is used as a reference standard in many studies,especially after sphincterotomy and balloon extraction of CBD *** ultrasonography is a useful tool for the intraoperative diagnosis of *** exploration of the CBD in cases of patients scheduled for cholecystectomy after an attack of ABP was not proven useful.A significant rate of the so-called idiopathic pancreatitis is actually caused by microlithiasis and/or biliary *** conclusion,the general algorithm for CBD stone detection starts with anamnesis,serum biochemistry and then TUS,followed by EUS or *** the end,bile duct microscopic an
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