Endoscopic ultrasonography versus endoscopic retrograde cholangiopancreatography in acute biliary pancreatitis: A systematic review

Stefania De Lisi, Gioacchino Leandro, Elisabetta Buscarini

Research output: Contribution to journalArticle

Abstract

Background: Acute biliary pancreatitis (ABP) is a clinical condition that can rapidly evolve into a life-threatening one. Endoscopic retrograde cholangiopancreatography (ERCP) has been considered the standard treatment of ABP for many years, though it entails the risk of morbidity and mortality. Endoscopic ultrasonography (EUS) can reliably diagnose choledocholithiasis avoiding unnecessary ERCP in patients with no stones in the biliary tract. Aim: We undertook a systematic review of the randomized controlled trials and clinical trials comparing EUS and ERCP to evaluate procedure performance, complication rates, clinical course of pancreatitis, and hospital stay according to the treatment given. Methods: A computerized bibliographic search was performed from 1994 to April 2010. Two reviewers assessed the methodological quality of eligible trials and independently extracted data from the included trials. Results: Seven studies enrolled 545 patients with acute pancreatitis of suspected biliary origin. Only one was a randomized controlled trial. EUS had a lower failure rate than ERCP in all the studies included, avoiding ERCP in 71.2% of cases. No complications were related to EUS, whereas sphincterotomy was associated with bleeding in up to 22% of patients. The procedures did not influence the clinical course of pancreatitis. Conclusion: A strategy based on EUS before ERCP in patients with ABP may be an effective alternative to diagnostic ERCP.

Original languageEnglish
Pages (from-to)367-374
Number of pages8
JournalEuropean Journal of Gastroenterology and Hepatology
Volume23
Issue number5
DOIs
Publication statusPublished - May 2011

Fingerprint

Endosonography
Endoscopic Retrograde Cholangiopancreatography
Pancreatitis
Randomized Controlled Trials
Choledocholithiasis
Biliary Tract
Length of Stay
Clinical Trials
Hemorrhage
Morbidity
Mortality
Therapeutics

Keywords

  • Acute biliary pancreatitis
  • choledocholithiasis
  • endoscopic retrograde cholangiopancreatography
  • endosonography

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Endoscopic ultrasonography versus endoscopic retrograde cholangiopancreatography in acute biliary pancreatitis : A systematic review. / De Lisi, Stefania; Leandro, Gioacchino; Buscarini, Elisabetta.

In: European Journal of Gastroenterology and Hepatology, Vol. 23, No. 5, 05.2011, p. 367-374.

Research output: Contribution to journalArticle

@article{2e23e001d3f74806baaba12a8a8a883c,
title = "Endoscopic ultrasonography versus endoscopic retrograde cholangiopancreatography in acute biliary pancreatitis: A systematic review",
abstract = "Background: Acute biliary pancreatitis (ABP) is a clinical condition that can rapidly evolve into a life-threatening one. Endoscopic retrograde cholangiopancreatography (ERCP) has been considered the standard treatment of ABP for many years, though it entails the risk of morbidity and mortality. Endoscopic ultrasonography (EUS) can reliably diagnose choledocholithiasis avoiding unnecessary ERCP in patients with no stones in the biliary tract. Aim: We undertook a systematic review of the randomized controlled trials and clinical trials comparing EUS and ERCP to evaluate procedure performance, complication rates, clinical course of pancreatitis, and hospital stay according to the treatment given. Methods: A computerized bibliographic search was performed from 1994 to April 2010. Two reviewers assessed the methodological quality of eligible trials and independently extracted data from the included trials. Results: Seven studies enrolled 545 patients with acute pancreatitis of suspected biliary origin. Only one was a randomized controlled trial. EUS had a lower failure rate than ERCP in all the studies included, avoiding ERCP in 71.2{\%} of cases. No complications were related to EUS, whereas sphincterotomy was associated with bleeding in up to 22{\%} of patients. The procedures did not influence the clinical course of pancreatitis. Conclusion: A strategy based on EUS before ERCP in patients with ABP may be an effective alternative to diagnostic ERCP.",
keywords = "Acute biliary pancreatitis, choledocholithiasis, endoscopic retrograde cholangiopancreatography, endosonography",
author = "{De Lisi}, Stefania and Gioacchino Leandro and Elisabetta Buscarini",
year = "2011",
month = "5",
doi = "10.1097/MEG.0b013e3283460129",
language = "English",
volume = "23",
pages = "367--374",
journal = "European Journal of Gastroenterology and Hepatology",
issn = "0954-691X",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Endoscopic ultrasonography versus endoscopic retrograde cholangiopancreatography in acute biliary pancreatitis

T2 - A systematic review

AU - De Lisi, Stefania

AU - Leandro, Gioacchino

AU - Buscarini, Elisabetta

PY - 2011/5

Y1 - 2011/5

N2 - Background: Acute biliary pancreatitis (ABP) is a clinical condition that can rapidly evolve into a life-threatening one. Endoscopic retrograde cholangiopancreatography (ERCP) has been considered the standard treatment of ABP for many years, though it entails the risk of morbidity and mortality. Endoscopic ultrasonography (EUS) can reliably diagnose choledocholithiasis avoiding unnecessary ERCP in patients with no stones in the biliary tract. Aim: We undertook a systematic review of the randomized controlled trials and clinical trials comparing EUS and ERCP to evaluate procedure performance, complication rates, clinical course of pancreatitis, and hospital stay according to the treatment given. Methods: A computerized bibliographic search was performed from 1994 to April 2010. Two reviewers assessed the methodological quality of eligible trials and independently extracted data from the included trials. Results: Seven studies enrolled 545 patients with acute pancreatitis of suspected biliary origin. Only one was a randomized controlled trial. EUS had a lower failure rate than ERCP in all the studies included, avoiding ERCP in 71.2% of cases. No complications were related to EUS, whereas sphincterotomy was associated with bleeding in up to 22% of patients. The procedures did not influence the clinical course of pancreatitis. Conclusion: A strategy based on EUS before ERCP in patients with ABP may be an effective alternative to diagnostic ERCP.

AB - Background: Acute biliary pancreatitis (ABP) is a clinical condition that can rapidly evolve into a life-threatening one. Endoscopic retrograde cholangiopancreatography (ERCP) has been considered the standard treatment of ABP for many years, though it entails the risk of morbidity and mortality. Endoscopic ultrasonography (EUS) can reliably diagnose choledocholithiasis avoiding unnecessary ERCP in patients with no stones in the biliary tract. Aim: We undertook a systematic review of the randomized controlled trials and clinical trials comparing EUS and ERCP to evaluate procedure performance, complication rates, clinical course of pancreatitis, and hospital stay according to the treatment given. Methods: A computerized bibliographic search was performed from 1994 to April 2010. Two reviewers assessed the methodological quality of eligible trials and independently extracted data from the included trials. Results: Seven studies enrolled 545 patients with acute pancreatitis of suspected biliary origin. Only one was a randomized controlled trial. EUS had a lower failure rate than ERCP in all the studies included, avoiding ERCP in 71.2% of cases. No complications were related to EUS, whereas sphincterotomy was associated with bleeding in up to 22% of patients. The procedures did not influence the clinical course of pancreatitis. Conclusion: A strategy based on EUS before ERCP in patients with ABP may be an effective alternative to diagnostic ERCP.

KW - Acute biliary pancreatitis

KW - choledocholithiasis

KW - endoscopic retrograde cholangiopancreatography

KW - endosonography

UR - http://www.scopus.com/inward/record.url?scp=79955051329&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955051329&partnerID=8YFLogxK

U2 - 10.1097/MEG.0b013e3283460129

DO - 10.1097/MEG.0b013e3283460129

M3 - Article

C2 - 21487299

AN - SCOPUS:79955051329

VL - 23

SP - 367

EP - 374

JO - European Journal of Gastroenterology and Hepatology

JF - European Journal of Gastroenterology and Hepatology

SN - 0954-691X

IS - 5

ER -