Antonini Filippo, Belfiori Valerio, Pagano Nico, Buscarini Elisabetta, De Minicis Samuele, Lo Cascio Massimiliano, Marraccini Barbara, Piergallini Simona, Rossetti Pamela, Andrenacci Elena, Macarri Giampiero, Pezzilli Raffaele
From the *Department of Gastroenterology, A. Murri Hospital, Polytechnic University of Marche, Fermo; †Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital, Bologna; and ‡Department of Gastroenterology, Maggiore Hospital, Crema, Italy.
Pancreas. 2017 Apr;46(4):524-527. doi: 10.1097/MPA.0000000000000796.
We have previously shown that at least 50% of patients with asymptomatic chronic pancreatic hyperenzymemia (ACPH) may develop morphological pancreatic alterations. Endoscopic ultrasonography (EUS) may detect small lesions, and its sensitivity seems to be higher than other imaging techniques. The aim of this study was to evaluate whether EUS may modify the management of patients having ACPH.
In 2 referral centers for pancreatic disease, a retrospective analysis of prospectively enrolled patients with ACPH was conducted.
Seventy-three patients with ACPH were enrolled for the purpose of this study. Endoscopic ultrasonography was performed as the last examination in 45 subjects who resulted negative at previous imaging studies (abdominal ultrasound, computed tomography, magnetic resonance imaging associated with cholangiopancreatography). Using EUS in 7 subjects, abnormalities were found in the following: 3 branch-duct intraductal papillary mucinous neoplasms, 1 duodenal diverticulum, 1 annular pancreas, 1 findings suggestive of chronic pancreatitis, and 1 undefined cyst (<5 mm).
Endoscopic ultrasonography is able to detect alteration not found by other imaging technique in 15.5% of patients with ACPH and may be useful to select those patients who require a more strict follow-up.
我们之前已经表明，至少50%的无症状慢性胰腺酶血症（ACPH）患者可能会出现胰腺形态改变。内镜超声检查（EUS）能够检测出小病变，其敏感性似乎高于其他成像技术。本研究的目的是评估EUS是否会改变ACPH患者的管理方式。
在2个胰腺疾病转诊中心，对前瞻性纳入的ACPH患者进行了回顾性分析。
本研究共纳入73例ACPH患者。45例在之前的影像学检查（腹部超声、计算机断层扫描、与胰胆管造影相关的磁共振成像）中结果为阴性的受试者，将内镜超声检查作为最后一项检查。在7例受试者中使用EUS，发现以下异常情况：3例分支导管内乳头状黏液性肿瘤、1例十二指肠憩室、1例环状胰腺、1例提示慢性胰腺炎的表现以及1例未明确的囊肿（<5mm）。
内镜超声检查能够在15.5%的ACPH患者中检测出其他成像技术未发现的改变，可能有助于筛选出那些需要更严格随访的患者。
