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Endoscopic ultrasound (EUS) and the endoscopic pancreatic function test (ePFT) are the most sensitive morphological and functional methods in this setting. EUS\u2010elastography allows for the quantification (strain ratio) of pancreatic fibrosis, and the dynamic evaluation of the main pancreatic duct compliance provides additional information. We developed a multimodal EUS\u2010based approach for the evaluation of the pancreas by integrating these four methods in a single procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aim to describe morphological and functional pancreatic abnormalities in patients with clinical suspicion of chronic pancreatitis and inconclusive EUS findings by using the multimodal EUS\u2010based approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, cross\u2010sectional, observational study of patients with clinically suspected chronic pancreatitis and indeterminate EUS criteria of the disease. EUS criteria of chronic pancreatitis, quantitative pancreatic elastography, ePFT and compliance of the main pancreatic duct were evaluated in a single procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 53 patients with 3\u20134 EUS criteria of chronic pancreatitis were included (mean age 39.7 years, 29\u00a0male). Strain ratio was abnormally high in all patients. Peak bicarbonate concentration was decreased in 43 patients (81.1%) and the main pancreatic duct compliance was reduced in 41 patients (77.3%). Some 34 patients (64.1%) had abnormal results at EUS, elastography, ePFT and compliance of the main pancreatic duct.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A multimodal EUS\u2010based test for the morphological and functional evaluation of the pancreas is presented, which allows detecting mild pancreatic abnormalities in patients with suspected early chronic pancreatitis. The presence of abnormal morphological and functional evaluation of the pancreas could support the clinical suspicion of early chronic pancreatitis in the appropriate clinical setting.<\/jats:p><\/jats:sec>","DOI":"10.1177\/2050640620936810","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T06:43:10Z","timestamp":1592980990000},"page":"790-797","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Endoscopic ultrasound\u2010based multimodal evaluation of the pancreas in patients with suspected early chronic pancreatitis"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8283-3185","authenticated-orcid":false,"given":"J Enrique","family":"Dom\u00ednguez\u2010Mu\u00f1oz","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Spain"},{"name":"Health Research Institute University Hospital of Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Lari\u00f1o\u2010Noia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Spain"},{"name":"Health Research Institute University Hospital of Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Alvarez\u2010Castro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Spain"},{"name":"Health Research Institute University Hospital of Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Nieto","sequence":"additional","affiliation":[{"name":"Health Research Institute University Hospital of Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Lojo","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry University Hospital of Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul","family":"Leal","sequence":"additional","affiliation":[{"name":"Health Research Institute University Hospital of Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1826-2282","authenticated-orcid":false,"given":"Daniel","family":"de la Iglesia\u2010Garcia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Spain"},{"name":"Health Research Institute University Hospital of Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julio","family":"Iglesias\u2010Garcia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology University Hospital of Santiago de Compostela Spain"},{"name":"Health Research Institute University Hospital of Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050640616684695"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","unstructured":"WhitcombDC ShimosegawaT ChariST et al. 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