Assessing the value of endoscopic ultrasound in predicting symptom severity and long-term clinical course in chronic pancreatitis

HPB (Oxford). 2017 Oct;19(10):868-873. doi: 10.1016/j.hpb.2017.05.012. Epub 2017 Jul 15.

Abstract

Background: To date, no studies have evaluated the correlation between number of endoscopic ultrasound (EUS) criteria met for chronic pancreatitis (CP) and symptom severity over the course of the disease. This study assessed the relationship between number of EUS-based diagnostic criteria for CP and CP severity over time.

Methods: A University of Louisville database was queried for patients undergoing EUS due to concern for chronic pancreatitis between 2005 and 2016. Patients were grouped based on EUS criteria met for CP and groups were compared along outcome and procedural variables.

Results: Of a total of 243 patients, 24, 129, and 90 patients met 1-3, 4-5, and ≥6 EUS diagnostic criteria, respectively. Median follow-up time was 33 months. Along all follow-up parameters, number of diagnostic criteria was positively correlated with an increased percentage of patients requiring operative intervention for chronic pancreatitis on univariate and multivariate analysis.

Conclusions: In addition to the role of EUS criteria in establishing the diagnostic severity of patients with symptomatic chronic pancreatitis, the number of EUS-based criteria may help predict patients who will eventually require operative intervention and thus prompt referral to a pancreatobiliary surgeon earlier in the course of a patient's disease.

MeSH terms

  • Databases, Factual
  • Endosonography*
  • Female
  • Humans
  • Kentucky
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Pancreatitis, Chronic / complications
  • Pancreatitis, Chronic / diagnostic imaging*
  • Pancreatitis, Chronic / surgery
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Time Factors