Smartest Doc
Low yield of significant findings on endoscopic retrograde cholangiopancreatography in patients with pancreatobiliary pain and no objective findings
Digestive Diseases and Sciences, 06/15/2012
Imler TD et al. – Endoscopic retrograde cholangiopancreatography (ERCP) in this high–risk population requires detailed informed consent, availability of SOM to increase the diagnostic yield, and skills in placing prophylactic pancreatic stents. It is the belief that patients without objective findings of pancreatobiliary disease that would explain their subjective complaints should not undergo diagnostic ERCP.
Methods- Entry criteria of this study included:
- ERCP with attempt at visualization of both the biliary tree and pancreatic duct,
- Suspected of having abdominal pain of pancreatobiliary origin,
- Biliary or pancreatic type III by the modified Geenen–Hogan classification, li>
- Never undergone sphincterotomy,
- Attempted manometry of both sphincters.
- A total of 265 patients met entry criteria.
- Significant findings were found in seven patients (2.6 %): choledococoele
- Anomalous pancreatobiliary ductal union
- Mild–moderate chronic pancreatitis
- And pancreatic duct filling defect suspicious for IPMN
- Potentially significant in 25 patients (9.4 %) were: equivocal chronic pancreatitis
- Incomplete
- And complete pancreas divisum (20).
- SOD was diagnosed in 77.7 %. 11.3 % had undergone a previous diagnostic ERCP.
