Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study

D.S. Umans; H.C. Timmerhuis; N.D. Hallensleben; S.A. Bouwense; M.P.G.F. Anten; A. Bhalla; R.A. Bijlsma; M.A. Boermeester; M.A. Brink; L. Hol; M.J. Bruno; W.L. Curvers; H.M. van Dullemen; B.C. van Eijck; G.W. Erkelens; P. Fockens; E.J.M. van Geenen; W.L. Hazen; C.V. Hoge; A. Inderson; L.M. Kager; S.D. Kuiken; L.E. Perk; J.W. Poley; R. Quispel; T.E. Romkens; H.C. van Santvoort; A.C.I.T.L. Tan; A.Y. Thijssen; N.G. Venneman; F.P. Vleggaar; A.M.C.J. Voorburg; R.L.J. van Wanrooij; B. Witteman; R.C. Verdonk; M.G. Besselink; J.E. van Hooft

doi:10.1136/bmjopen-2019-035504

Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study

D.S. Umans^*, H.C. Timmerhuis, N.D. Hallensleben, S.A. Bouwense, M.P.G.F. Anten, A. Bhalla, R.A. Bijlsma, M.A. Boermeester, M.A. Brink, L. Hol, M.J. Bruno, W.L. Curvers, H.M. van Dullemen, B.C. van Eijck, G.W. Erkelens, P. Fockens, E.J.M. van Geenen, W.L. Hazen, C.V. Hoge, A. IndersonL.M. Kager, S.D. Kuiken, L.E. Perk, J.W. Poley, R. Quispel, T.E. Romkens, H.C. van Santvoort, A.C.I.T.L. Tan, A.Y. Thijssen, N.G. Venneman, F.P. Vleggaar, A.M.C.J. Voorburg, R.L.J. van Wanrooij, B. Witteman, R.C. Verdonk, M.G. Besselink, J.E. van Hooft

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Introduction Idiopathic acute pancreatitis (IAP) remains a dilemma for physicians as it is uncertain whether patients with IAP may actually have an occult aetiology. It is unclear to what extent additional diagnostic modalities such as endoscopic ultrasonography (EUS) are warranted after a first episode of IAP in order to uncover this aetiology. Failure to timely determine treatable aetiologies delays appropriate treatment and might subsequently cause recurrence of acute pancreatitis. Therefore, the aim of the Pancreatitis of Idiopathic origin: Clinical added value of endoscopic UltraSonography (PICUS) Study is to determine the value of routine EUS in determining the aetiology of pancreatitis in patients with a first episode of IAP. Methods and analysis PICUS is designed as a multicentre prospective cohort study of 106 patients with a first episode of IAP after complete standard diagnostic work-up, in whom a diagnostic EUS will be performed. Standard diagnostic work-up will include a complete personal and family history, laboratory tests including serum alanine aminotransferase, calcium and triglyceride levels and imaging by transabdominal ultrasound, magnetic resonance imaging or magnetic resonance cholangiopancreaticography after clinical recovery from the acute pancreatitis episode. The primary outcome measure is detection of aetiology by EUS. Secondary outcome measures include pancreatitis recurrence rate, severity of recurrent pancreatitis, readmission, additional interventions, complications, length of hospital stay, quality of life, mortality and costs, during a follow-up period of 12 months. Ethics and dissemination PICUS is conducted according to the Declaration of Helsinki and Guideline for Good Clinical Practice. Five medical ethics review committees assessed PICUS (Medical Ethics Review Committee of Academic Medical Center, University Medical Center Utrecht, Radboud University Medical Center, Erasmus Medical Center and Maastricht University Medical Center). The results will be submitted for publication in an international peer-reviewed journal.

Original language	English
Article number	035504
Number of pages	9
Journal	BMJ Open
Volume	10
Issue number	8
DOIs	https://doi.org/10.1136/bmjopen-2019-035504
Publication status	Published - 20 Aug 2020

Keywords

atlanta classification
complications
endoscopy
epidemiology
etiology
eus
gallstone pancreatitis
hepatobiliary disease
infected necrotizing pancreatitis
magnetic-resonance cholangiopancreatography
management
pancreatic disease
ultrasound
GALLSTONE PANCREATITIS
ETIOLOGY
EUS
MANAGEMENT
MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY
INFECTED NECROTIZING PANCREATITIS
ULTRASOUND
COMPLICATIONS
ATLANTA CLASSIFICATION
EPIDEMIOLOGY

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Umans, D. S., Timmerhuis, H. C., Hallensleben, N. D., Bouwense, S. A., Anten, M. P. G. F., Bhalla, A., Bijlsma, R. A., Boermeester, M. A., Brink, M. A., Hol, L., Bruno, M. J., Curvers, W. L., van Dullemen, H. M., van Eijck, B. C., Erkelens, G. W., Fockens, P., van Geenen, E. J. M., Hazen, W. L., Hoge, C. V., ... van Hooft, J. E. (2020). Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study. BMJ Open, 10(8), Article 035504. https://doi.org/10.1136/bmjopen-2019-035504

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title = "Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study",

abstract = "Introduction Idiopathic acute pancreatitis (IAP) remains a dilemma for physicians as it is uncertain whether patients with IAP may actually have an occult aetiology. It is unclear to what extent additional diagnostic modalities such as endoscopic ultrasonography (EUS) are warranted after a first episode of IAP in order to uncover this aetiology. Failure to timely determine treatable aetiologies delays appropriate treatment and might subsequently cause recurrence of acute pancreatitis. Therefore, the aim of the Pancreatitis of Idiopathic origin: Clinical added value of endoscopic UltraSonography (PICUS) Study is to determine the value of routine EUS in determining the aetiology of pancreatitis in patients with a first episode of IAP. Methods and analysis PICUS is designed as a multicentre prospective cohort study of 106 patients with a first episode of IAP after complete standard diagnostic work-up, in whom a diagnostic EUS will be performed. Standard diagnostic work-up will include a complete personal and family history, laboratory tests including serum alanine aminotransferase, calcium and triglyceride levels and imaging by transabdominal ultrasound, magnetic resonance imaging or magnetic resonance cholangiopancreaticography after clinical recovery from the acute pancreatitis episode. The primary outcome measure is detection of aetiology by EUS. Secondary outcome measures include pancreatitis recurrence rate, severity of recurrent pancreatitis, readmission, additional interventions, complications, length of hospital stay, quality of life, mortality and costs, during a follow-up period of 12 months. Ethics and dissemination PICUS is conducted according to the Declaration of Helsinki and Guideline for Good Clinical Practice. Five medical ethics review committees assessed PICUS (Medical Ethics Review Committee of Academic Medical Center, University Medical Center Utrecht, Radboud University Medical Center, Erasmus Medical Center and Maastricht University Medical Center). The results will be submitted for publication in an international peer-reviewed journal.",

keywords = "atlanta classification, complications, endoscopy, epidemiology, etiology, eus, gallstone pancreatitis, hepatobiliary disease, infected necrotizing pancreatitis, magnetic-resonance cholangiopancreatography, management, pancreatic disease, ultrasound, GALLSTONE PANCREATITIS, ETIOLOGY, EUS, MANAGEMENT, MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY, INFECTED NECROTIZING PANCREATITIS, ULTRASOUND, COMPLICATIONS, ATLANTA CLASSIFICATION, EPIDEMIOLOGY",

author = "D.S. Umans and H.C. Timmerhuis and N.D. Hallensleben and S.A. Bouwense and M.P.G.F. Anten and A. Bhalla and R.A. Bijlsma and M.A. Boermeester and M.A. Brink and L. Hol and M.J. Bruno and W.L. Curvers and {van Dullemen}, H.M. and {van Eijck}, B.C. and G.W. Erkelens and P. Fockens and {van Geenen}, E.J.M. and W.L. Hazen and C.V. Hoge and A. Inderson and L.M. Kager and S.D. Kuiken and L.E. Perk and J.W. Poley and R. Quispel and T.E. Romkens and {van Santvoort}, H.C. and A.C.I.T.L. Tan and A.Y. Thijssen and N.G. Venneman and F.P. Vleggaar and A.M.C.J. Voorburg and {van Wanrooij}, R.L.J. and B. Witteman and R.C. Verdonk and M.G. Besselink and {van Hooft}, J.E.",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.",

year = "2020",

month = aug,

day = "20",

doi = "10.1136/bmjopen-2019-035504",

language = "English",

volume = "10",

journal = "BMJ Open",

issn = "2044-6055",

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Umans, DS, Timmerhuis, HC, Hallensleben, ND, Bouwense, SA, Anten, MPGF, Bhalla, A, Bijlsma, RA, Boermeester, MA, Brink, MA, Hol, L, Bruno, MJ, Curvers, WL, van Dullemen, HM, van Eijck, BC, Erkelens, GW, Fockens, P, van Geenen, EJM, Hazen, WL, Hoge, CV, Inderson, A, Kager, LM, Kuiken, SD, Perk, LE, Poley, JW, Quispel, R, Romkens, TE, van Santvoort, HC, Tan, ACITL, Thijssen, AY, Venneman, NG, Vleggaar, FP, Voorburg, AMCJ, van Wanrooij, RLJ, Witteman, B, Verdonk, RC, Besselink, MG & van Hooft, JE 2020, 'Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study', BMJ Open, vol. 10, no. 8, 035504. https://doi.org/10.1136/bmjopen-2019-035504

TY - JOUR

T1 - Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study

AU - Umans, D.S.

AU - Timmerhuis, H.C.

AU - Hallensleben, N.D.

AU - Bouwense, S.A.

AU - Anten, M.P.G.F.

AU - Bhalla, A.

AU - Bijlsma, R.A.

AU - Boermeester, M.A.

AU - Brink, M.A.

AU - Hol, L.

AU - Bruno, M.J.

AU - Curvers, W.L.

AU - van Dullemen, H.M.

AU - van Eijck, B.C.

AU - Erkelens, G.W.

AU - Fockens, P.

AU - van Geenen, E.J.M.

AU - Hazen, W.L.

AU - Hoge, C.V.

AU - Inderson, A.

AU - Kager, L.M.

AU - Kuiken, S.D.

AU - Perk, L.E.

AU - Poley, J.W.

AU - Quispel, R.

AU - Romkens, T.E.

AU - van Santvoort, H.C.

AU - Tan, A.C.I.T.L.

AU - Thijssen, A.Y.

AU - Venneman, N.G.

AU - Vleggaar, F.P.

AU - Voorburg, A.M.C.J.

AU - van Wanrooij, R.L.J.

AU - Witteman, B.

AU - Verdonk, R.C.

AU - Besselink, M.G.

AU - van Hooft, J.E.

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.

PY - 2020/8/20

Y1 - 2020/8/20

N2 - Introduction Idiopathic acute pancreatitis (IAP) remains a dilemma for physicians as it is uncertain whether patients with IAP may actually have an occult aetiology. It is unclear to what extent additional diagnostic modalities such as endoscopic ultrasonography (EUS) are warranted after a first episode of IAP in order to uncover this aetiology. Failure to timely determine treatable aetiologies delays appropriate treatment and might subsequently cause recurrence of acute pancreatitis. Therefore, the aim of the Pancreatitis of Idiopathic origin: Clinical added value of endoscopic UltraSonography (PICUS) Study is to determine the value of routine EUS in determining the aetiology of pancreatitis in patients with a first episode of IAP. Methods and analysis PICUS is designed as a multicentre prospective cohort study of 106 patients with a first episode of IAP after complete standard diagnostic work-up, in whom a diagnostic EUS will be performed. Standard diagnostic work-up will include a complete personal and family history, laboratory tests including serum alanine aminotransferase, calcium and triglyceride levels and imaging by transabdominal ultrasound, magnetic resonance imaging or magnetic resonance cholangiopancreaticography after clinical recovery from the acute pancreatitis episode. The primary outcome measure is detection of aetiology by EUS. Secondary outcome measures include pancreatitis recurrence rate, severity of recurrent pancreatitis, readmission, additional interventions, complications, length of hospital stay, quality of life, mortality and costs, during a follow-up period of 12 months. Ethics and dissemination PICUS is conducted according to the Declaration of Helsinki and Guideline for Good Clinical Practice. Five medical ethics review committees assessed PICUS (Medical Ethics Review Committee of Academic Medical Center, University Medical Center Utrecht, Radboud University Medical Center, Erasmus Medical Center and Maastricht University Medical Center). The results will be submitted for publication in an international peer-reviewed journal.

AB - Introduction Idiopathic acute pancreatitis (IAP) remains a dilemma for physicians as it is uncertain whether patients with IAP may actually have an occult aetiology. It is unclear to what extent additional diagnostic modalities such as endoscopic ultrasonography (EUS) are warranted after a first episode of IAP in order to uncover this aetiology. Failure to timely determine treatable aetiologies delays appropriate treatment and might subsequently cause recurrence of acute pancreatitis. Therefore, the aim of the Pancreatitis of Idiopathic origin: Clinical added value of endoscopic UltraSonography (PICUS) Study is to determine the value of routine EUS in determining the aetiology of pancreatitis in patients with a first episode of IAP. Methods and analysis PICUS is designed as a multicentre prospective cohort study of 106 patients with a first episode of IAP after complete standard diagnostic work-up, in whom a diagnostic EUS will be performed. Standard diagnostic work-up will include a complete personal and family history, laboratory tests including serum alanine aminotransferase, calcium and triglyceride levels and imaging by transabdominal ultrasound, magnetic resonance imaging or magnetic resonance cholangiopancreaticography after clinical recovery from the acute pancreatitis episode. The primary outcome measure is detection of aetiology by EUS. Secondary outcome measures include pancreatitis recurrence rate, severity of recurrent pancreatitis, readmission, additional interventions, complications, length of hospital stay, quality of life, mortality and costs, during a follow-up period of 12 months. Ethics and dissemination PICUS is conducted according to the Declaration of Helsinki and Guideline for Good Clinical Practice. Five medical ethics review committees assessed PICUS (Medical Ethics Review Committee of Academic Medical Center, University Medical Center Utrecht, Radboud University Medical Center, Erasmus Medical Center and Maastricht University Medical Center). The results will be submitted for publication in an international peer-reviewed journal.

KW - atlanta classification

KW - complications

KW - endoscopy

KW - epidemiology

KW - etiology

KW - eus

KW - gallstone pancreatitis

KW - hepatobiliary disease

KW - infected necrotizing pancreatitis

KW - magnetic-resonance cholangiopancreatography

KW - management

KW - pancreatic disease

KW - ultrasound

KW - GALLSTONE PANCREATITIS

KW - ETIOLOGY

KW - EUS

KW - MANAGEMENT

KW - MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY

KW - INFECTED NECROTIZING PANCREATITIS

KW - ULTRASOUND

KW - COMPLICATIONS

KW - ATLANTA CLASSIFICATION

KW - EPIDEMIOLOGY

U2 - 10.1136/bmjopen-2019-035504

DO - 10.1136/bmjopen-2019-035504

M3 - Article

C2 - 32819938

SN - 2044-6055

VL - 10

JO - BMJ Open

JF - BMJ Open

IS - 8

M1 - 035504

ER -