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World J Gastroenterol. Jun 21, 2010; 16(23): 2841-2850
Published online Jun 21, 2010. doi: 10.3748/wjg.v16.i23.2841
Endoscopic ultrasound for the diagnosis of chronic pancreatitis
Tyler Stevens, Mansour A Parsi
Tyler Stevens, Mansour A Parsi, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, United States
Author contributions: Stevens T wrote and gave final approval of the manuscript; Parsi MA provided critical revision for intellectual content.
Correspondence to: Tyler Stevens, MD, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland Ohio, 9500 Euclid Avenue, A31, Cleveland, OH 44195, United States. stevent@ccf.org
Telephone: +1-216-4442336 Fax: +1-216-4446284
Received: November 24, 2009
Revised: January 5, 2010
Accepted: January 12, 2010
Published online: June 21, 2010
Abstract

Endoscopic ultrasound (EUS) has become a well accepted test for the diagnosis of chronic pancreatitis. Advantages include its ability to detect subtle and severe changes of the pancreatic duct and parenchyma, and its relative safety compared with endoscopic retrograde cholangiopancreatography. Limitations include inter- and intra-observer variability, operator dependence, and an incomplete understanding of its true accuracy. The Rosemont classification has recently been proposed as a weighted, standardized method that may improve EUS chronic pancreatitis scoring. This paper reviews the published evidence regarding the accuracy of EUS in chronic pancreatitis diagnosis, and enumerates the emerging technologies that have been recently studied which may ultimately improve endosonographic imaging of the pancreas.

Keywords: Chronic pancreatitis, Contrast-enhanced endoscopic ultrasound, Diagnosis, Digital image analysis, Elastography, Endoscopic ultrasound, Pancreatic function testing, Rosemont classification