Acute alvleesklierontsteking van onbekende oorzaak: de rol van een inwendige echo in het vaststellen van een oorzaak

Idiopathic acute pancreatitis (IAP) remains a dilemma for many physicians as it is unclear to what extent additional diagnostic modalities such as endoscopic ultrasound (EUS) are warranted after a first episode of IAP in order to determine an aetiology. The aim of the PICUS study is to determine the value of EUS in patients with a first episode of IAP with regard to determining an aetiology and preventing recurrent pancreatitis.

The PICUS study is designed as a multicentre prospective cohort study of 106 patients with (presumed) idiopathic acute pancreatitis after standard work-up in whom, following the current guidelines (1), an EUS will be performed. If an aetiology is found during endoscopic ultrasonography, patients will receive appropriate treatment in accordance with the current guidelines. Follow-up will be 12 months, during which patients will be asked to fill out a questionnaire at baseline, six months and 12 months after inclusion. The primary outcome measure is detection of aetiology by EUS. Secondary outcome measures are recurrence rate, severity of recurrent pancreatitis, readmission, additional interventions, complications, length of hospital stay, quality of life, mortality and costs.

The PICUS study will potentially improve the diagnostic process in “presumed” IAP patients, lower recurrence rate, avoid unnecessary interventions and positively impact quality of life of pancreatitis patients.

In this study we hope to provide early detection of a treatable cause of pancreatitis by endoscopic ultrasound, and we hope to prevent unnecessary exposure to the rare but serious complications of cholecystectomy. This way, we will be able to prevent readmissions as well as complications and directly improve health and quality of life of the patient.

The primary outcome measure will be evaluated during endoscopic ultrasound, or, if applicable, after pathology reports of histological or cytological specimens have become available.



Questionnaires (Short Form-36) will be filled out after inclusion, at six months and at 12 months.



The other secondary outcome measures will be evaluated at 12 months after inclusion.

Endoscopic ultrasound