4.4 Review

Various Modalities Accurate in Diagnosing a Disrupted or Disconnected Pancreatic Duct in Acute Pancreatitis: A Systematic Review

期刊

DIGESTIVE DISEASES AND SCIENCES
卷 66, 期 5, 页码 1415-1424

出版社

SPRINGER
DOI: 10.1007/s10620-020-06413-0

关键词

Acute necrotizing pancreatitis; Pancreatic fistula; Disrupted pancreatic duct; Disconnected pancreatic duct

资金

  1. St. Antonius Hospital Research Fund

向作者/读者索取更多资源

Various diagnostic modalities are accurate in diagnosing a disrupted pancreatic duct in patients with acute pancreatitis, with endoscopic ultrasound and endoscopic retrograde cholangiopancreatography showing a sensitivity of 100%. Amylase measurement in drain fluid should be standardized. Secretin-magnetic resonance cholangiopancreatography or magnetic resonance cholangiopancreatography are recommended as the first diagnostic modality due to their less invasive nature, but further prospective studies are needed.
Background Severe pancreatitis may result in a disrupted pancreatic duct, which is associated with a complicated clinical course. Diagnosis of a disrupted pancreatic duct is not standardized in clinical practice or international guidelines. We performed a systematic review of the literature on imaging modalities for diagnosing a disrupted pancreatic duct in patients with acute pancreatitis. Methods A systematic search was performed in PubMed, Embase and Cochrane library databases to identify all studies evaluating diagnostic modalities for the diagnosis of a disrupted pancreatic duct in acute pancreatitis. All data regarding diagnostic accuracy were extracted. Results We included 8 studies, evaluating five different diagnostic modalities in 142 patients with severe acute pancreatitis. Study quality was assessed, with proportionally divided high and low risk of bias and low applicability concerns in 75% of the studies. A sensitivity of 100% was reported for endoscopic ultrasound and endoscopic retrograde cholangiopancreatography. The sensitivity of magnetic resonance cholangiopancreatography with or without secretin was 83%. A sensitivity of 92% was demonstrated for a combined cohort of secretin-magnetic resonance cholangiopancreatography and magnetic resonance cholangiopancreatography. A sensitivity of 100% and specificity of 50% was found for amylase measurements in drain fluid compared with ERCP. Conclusions This review suggests that various diagnostic modalities are accurate in diagnosing a disrupted pancreatic duct in patients with acute pancreatitis. Amylase measurement in drain fluid should be standardized. Given the invasive nature of other modalities, secretin-magnetic resonance cholangiopancreatography or magnetic resonance cholangiopancreatography would be recommended as first diagnostic modality. Further prospective studies, however, are needed.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.4
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据