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- Title
Clinico-biochemical prediction of biliary cause of acute pancreatitis in the era of endoscopic ultrasonography.
- Authors
LIU, C. L.; FAN, S. T.; LO, C. M.; TSO, W. K.; WONG, Y.; POON, R. T. P.; LAM, C. M.; WONG, B. C.; WONG, J.
- Abstract
: Occult biliary stones escape detection on conventional investigations, and clinico-biochemical systems proposed for predicting biliary pancreatitis has low predictive values. : To evaluate the accuracy of clinico-biochemical parameters for prediction of biliary pancreatitis in patients undergoing endoscopic ultrasonography. : Early endoscopic ultrasonography was performed on 139 patients presenting with acute pancreatitis within 24 h of admission. The aetiologies of all patients were determined after complete evaluations, and clinico-biochemical characteristics of patients with a biliary cause (biliary group) and non-biliary causes (non-biliary group) were compared. : Biliary pancreatitis was diagnosed in 107 patients and 32 patients had non-biliary causes. The biliary group belonged to a significantly older age group, had a female predominance, significantly more derangement of liver function and a higher incidence of severe attack of acute pancreatitis. On multivariate analysis, female sex, age >58 years and serum alanine aminotransferase >150 U/L were independent predictive factors for biliary cause of acute pancreatitis. Using these three factors for prediction of biliary cause, the sensitivity was 93% and overall accuracy was 85%. : Clinico-biochemical prediction for biliary cause of acute pancreatitis improves in the era of endoscopic ultrasonography with a higher sensitivity and overall accuracy. In centres where endoscopic ultrasonography is inaccessible or local expertise is unavailable, clinico-biochemical prediction of biliary cause of acute pancreatitis may provide a useful alternative in the initial management of this group of patients.
- Subjects
PANCREATITIS; ENDOSCOPIC ultrasonography; DIAGNOSTIC ultrasonic imaging; ETIOLOGY of diseases; LIVER function tests; LIVER disease diagnosis
- Publication
Alimentary Pharmacology & Therapeutics, 2005, Vol 22, Issue 5, p423
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2005.02580.x