{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:16:02Z","timestamp":1790151362724,"version":"4.0.1"},"reference-count":37,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:p>\n            Background\u2002Idiopathic acute pancreatitis (IAP) has a 25\u200a% pancreatitis recurrence rate. Endoscopic ultrasonography (EUS) may diagnose treatable causes of IAP and hence prevent recurrence. The goal of this systematic review with meta-analysis is to determine the diagnostic yield of EUS and its impact on recurrence.<\/jats:p><jats:p>\n            Methods\u2002PubMed, EMBASE and the Cochrane Library were systematically searched for English studies on EUS in adults with IAP. The primary outcome was diagnostic yield. Secondary outcomes included recurrence. Methodological quality was assessed using the QUADAS-2 score. Meta-analysis was performed to calculate the pooled diagnostic yield and risk ratio with 95\u200a% confidence intervals (CI) using a random-effects model with inverse variance method.<\/jats:p><jats:p>\n            Results\u200222 studies were included, with 1490 IAP patients who underwent EUS.\u200aOverall diagnostic yield was 59\u200a% (874\u200a\/1490; 95\u200a%CI 52\u200a%\u200a\u2013\u200a66\u200a%). The most common etiologies were biliary (429\u200a\/1490; 30\u200a%, 95\u200a%CI 21\u200a%\u200a\u2013\u200a41\u200a%) and chronic pancreatitis (271\u200a\/1490; 12\u200a%, 95\u200a%CI 8\u200a%\u200a\u2013\u200a19\u200a%). In 2\u200a% of patients, neoplasms were detected (45\u200a\/1490; 95\u200a%CI 1\u200a%\u200a\u2013\u200a4\u200a%). There was no difference in yield between patients with or without recurrent IAP before EUS (risk ratio 0.89, 95\u200a%CI 0.71\u200a\u2013\u200a1.11).<\/jats:p><jats:p>\n            Conclusions\u2002EUS is able to identify a potential etiology in the majority of patients with IAP, detecting mostly biliary origin or chronic pancreatitis, but also neoplasms in 2\u200a% of patients. EUS may be associated with a reduction of recurrence rate. Future studies should include complete diagnostic work-up and preferably include patients with a first episode of IAP only.<\/jats:p>","DOI":"10.1055\/a-1183-3370","type":"journal-article","created":{"date-parts":[[2020,8,5]],"date-time":"2020-08-05T09:14:50Z","timestamp":1596618890000},"page":"955-964","source":"Crossref","is-referenced-by-count":31,"title":["Endoscopic ultrasonography can detect a cause in the majority of patients with idiopathic acute pancreatitis: a systematic review and meta-analysis"],"prefix":"10.1055","volume":"52","author":[{"given":"Devica S.","family":"Umans","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Research and Development, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos K.","family":"Rangkuti","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christa J.","family":"Sperna Weiland","sequence":"additional","affiliation":[{"name":"Department of Research and Development, St. Antonius Hospital, Nieuwegein, The Netherlands"},{"name":"Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hester C.","family":"Timmerhuis","sequence":"additional","affiliation":[{"name":"Department of Research and Development, St. Antonius Hospital, Nieuwegein, The Netherlands"},{"name":"Department of Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan A. W.","family":"Bouwense","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maastricht UMC+, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Fockens","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc G.","family":"Besselink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Verdonk","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, St. Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanin E.","family":"van Hooft","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Dutch Pancreatitis Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.pan.2017.01.005","article-title":"The incidence and aetiology of acute pancreatitis across Europe","volume":"17","author":"S E Roberts","year":"2017","journal-title":"Pancreatology"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.pan.2013.07.063","article-title":"IAP\/APA evidence-based guidelines for the management of acute pancreatitis","volume":"13","author":"Working Group IAP\/APA Acute Pancreatitis Guidelines","year":"2013","journal-title":"Pancreatology"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1038\/ajg.2016.240","article-title":"Prospective endoscopic ultrasound-based approach to the evaluation of idiopathic pancreatitis: causes, response to therapy, and long-term outcome","volume":"111","author":"C M Wilcox","year":"2016","journal-title":"Am J Gastroenterol"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1097\/SLA.0000000000001469","article-title":"Can laparoscopic cholecystectomy prevent recurrent idiopathic acute pancreatitis? A prospective randomized multicenter trial","volume":"262","author":"S Raty","year":"2015","journal-title":"Ann Surg"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.02.011","article-title":"Acute pancreatitis and pancreatic cancer risk: a nationwide matched-cohort study in Denmark","author":"J Kirkegard","year":"2018","journal-title":"Gastroenterology"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"D Moher","year":"2009","journal-title":"PLoS Medicine"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1001\/jama.283.15.2008","article-title":"Meta-analysis of observational studies in epidemiology: a proposal for reporting","volume":"283","author":"D F Stroup","year":"2000","journal-title":"JAMA"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"529","DOI":"10.7326\/0003-4819-155-8-201110180-00009","article-title":"QUADAS-2: A revised tool for the quality assessment of diagnostic accuracy studies","volume":"155","author":"P Whiting","year":"2011","journal-title":"Ann Intern Med"},{"key":"ref9","volume-title":"Endosonography. 2nd edn.","author":"R H Hawes","year":"2011"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"R DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"J P Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1016\/S0895-4356(01)00377-8","article-title":"Funnel plots for detecting bias in meta-analysis: Guidelines on choice of axis","volume":"54","author":"A C Jonathan","year":"2001","journal-title":"J Clin Epidemiol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1097\/00006676-200303000-00023","article-title":"The biochemical detection of biliary etiology of acute pancreatitis on admission: a revisit in the modern era of biliary imaging","volume":"26","author":"B J Ammori","year":"2003","journal-title":"Pancreas"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4103\/0976-5042.195725","article-title":"Prospective evaluation of yield of endoscopic ultrasonography in the etiological diagnosis of \u201cidiopathic\u201d acute pancreatitis","volume":"7","author":"N S Choudhary","year":"2016","journal-title":"J Dig Endosc"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/S0002-9343(00)00478-2","article-title":"Usefulness of endoscopic ultrasonography in patients with \u201cidiopathic\u201d acute pancreatitis","volume":"109","author":"J L Frossard","year":"2000","journal-title":"Am J Med"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.cgh.2006.06.023","article-title":"Is biliary microlithiasis a significant cause of idiopathic recurrent acute pancreatitis? A long-term follow-up study","volume":"5","author":"P K Garg","year":"2007","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s12664-013-0422-2","article-title":"Role of endoscopic ultrasonography in patients with first episode of idiopathic acute pancreatitis","volume":"33","author":"A Govil","year":"2014","journal-title":"Indian J Gastroenterol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1016\/j.gie.2010.12.030","article-title":"The role of intraductal US in the management of idiopathic recurrent pancreatitis without a definite cause on ERCP","volume":"73","author":"H S Kim","year":"2011","journal-title":"Gastrointest Endosc"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/S0016-5107(00)70382-8","article-title":"EUS for detection of occult cholelithiasis in patients with idiopathic pancreatitis","volume":"51","author":"C-L Liu","year":"2000","journal-title":"Gastrointest Endosc"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.clinre.2018.08.004","article-title":"The role of linear endosonography for the diagnosis of acute pancreatitis when other methods failed","volume":"43","author":"C V Lopes","year":"2019","journal-title":"Clin Res Hepatol Gastroenterol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1097\/00042737-199908000-00014","article-title":"Extensive aetiological investigations in acute pancreatitis: results of a 1-year prospective study","volume":"11","author":"B Maes","year":"1999","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.dld.2009.01.009","article-title":"Diagnostic yield of ERCP and secretin-enhanced MRCP and EUS in patients with acute recurrent pancreatitis of unknown aetiology","volume":"41","author":"A Mariani","year":"2009","journal-title":"Dig Liver Dis"},{"key":"ref25","first-page":"143","article-title":"Does endoscopic ultrasound have anything to offer in the diagnosis of idiopathic acute pancreatitis?","volume":"10","author":"G Morris-Stiff","year":"2009","journal-title":"JOP"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1046\/j.1365-2168.2000.01587.x","article-title":"Endoscopic ultrasonography in the evaluation of idiopathic acute pancreatitis","volume":"97","author":"S A Norton","year":"2000","journal-title":"Br J Surg"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"698","DOI":"10.4321\/S1130-01082010001200004","article-title":"Clinical impact of high-definition endoscopic ultrasonography (EUS) in a district hospital","volume":"102","author":"E Poves","year":"2010","journal-title":"Rev Esp Enferm Dig"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1023\/A:1019616711220","article-title":"Feasibility of and interest in combined endoscopic ultrasonography and biliary drainage in unexplained acute biliopancreatic disorders","volume":"47","author":"P-E Queneau","year":"2002","journal-title":"Dig Dis Sci"},{"key":"ref29","first-page":"133","article-title":"Role of endoscopic ultrasound in idiopathic acute pancreatitis with negative ultrasound, computed tomography, and magnetic resonance cholangiopancreatography","volume":"25","author":"S S Rana","year":"2012","journal-title":"Ann Gastroenterol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/MPA.0b013e318201654a","article-title":"Prospective comparison of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in the etiological diagnosis of \u201cidiopathic\u201d acute pancreatitis","volume":"40","author":"A Repiso Ortega","year":"2011","journal-title":"Pancreas"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1111\/j.1572-0241.2001.03609.x","article-title":"Endoscopic ultrasound in idiopathic acute pancreatitis","volume":"96","author":"M Tandon","year":"2001","journal-title":"Am J Gastroenterol"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1007\/s10620-013-2632-y","article-title":"Endoscopic ultrasound and magnetic resonance cholangiopancreatography in patients with idiopathic acute pancreatitis","volume":"58","author":"A Thevenot","year":"2013","journal-title":"Dig Dis Sci"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"375","DOI":"10.3109\/00365520903508894","article-title":"Diagnostic yield and reliability of endoscopic ultrasonography in patients with idiopathic acute pancreatitis","volume":"45","author":"J J Vila","year":"2010","journal-title":"Scand J Gastroenterol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/S0016-5107(04)02018-8","article-title":"A prospective comparison of the yield of EUS in primary vs. recurrent idiopathic acute pancreatitis","volume":"60","author":"I F Yusoff","year":"2004","journal-title":"Gastrointest Endosc"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1111\/j.1440-1746.2011.06755.x","article-title":"EUS in exploring the etiology of mild acute biliary pancreatitis with a negative finding of biliary origin by conventional radiological methods","volume":"26","author":"X Zhan","year":"2011","journal-title":"J Gastroenterol Hepatol"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.gie.2008.07.043","article-title":"EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification","volume":"69","author":"M F Catalano","year":"2009","journal-title":"Gastrointest Endosc"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1177\/2050640619890462","article-title":"The diagnostic work-up and outcomes of \u2018presumed\u2019 idiopathic acute pancreatitis: A post-hoc analysis of a multicentre observational cohort","volume":"8","author":"N D Hallensleben","year":"2020","journal-title":"United European Gastroenterol J"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s11894-010-0170-8","article-title":"Pancreas divisum","volume":"13","author":"M J DiMagno","year":"2011","journal-title":"Curr Gastroenterol Rep"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"1694","DOI":"10.1007\/s11605-019-04272-3","article-title":"Endoscopic ultrasound for routine assessment in idiopathic acute pancreatitis","volume":"23","author":"R Pereira","year":"2019","journal-title":"J Gastrointest Surg"}],"container-title":["Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1183-3370.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T23:31:53Z","timestamp":1603841513000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1183-3370"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,17]]},"references-count":37,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,10,27]]},"published-print":{"date-parts":[[2020,11]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1183-3370","relation":{},"ISSN":["0013-726X","1438-8812"],"issn-type":[{"value":"0013-726X","type":"print"},{"value":"1438-8812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,17]]}}}