Impact of Imaging Techniques in the Assessment of Gallstone Pancreatitis

Abstract

From the category of biliary disease, gallstones registered an increase during the last years, approximately 6% of men and 9% of women being affected by the pathology in the United States only. In western countries between 10-20% of the adult population is suffering from cholelithiasis. Although increasing age is a major risk factor for their formation, late studies correlate gallstones appearance with an age decrease for the onset of symptoms. We therefore face a younger population manifesting pain and sometimes functional disability. In accordance with statistical analysis, the economic impact of gallstones in highly industrialized countries such as United States produces costs of up to 6.5 billion dollars annually. In this context, the appropriate timing for intervention becomes a factor of major interest. The present review uses 28 articles and specialized literature. Article selection was based on keywords and followed the effectiveness of imaging investigation such as ultrasound, CT and MRI for patients diagnosed with cholelithiasis. Since a direct comparison between the imaging investigation techniques is not concluding we have tried to establish the sensitivity and specificity offered by each imaging assessment. The comparative analysis revealed a p Kruskal-Wallis <0.001 for sensitivity and p Kruskal-Wallis=0.474 for specificity.

Keywords: Gallstones; acute pancreatitis; cholelithiasis; imaging investigation.

Figure 1

PRISMA Diagram

Figure 2

Axial MRI an CT findings: Gallstones, acute inflammatory changes of the pancreas and peripancreatic soft tissue (Authors’ unpublished data).

Figure 3

Axial and coronal sections of an MRI examination depicting inflammatory changes of the pancreas and peripancreatic soft tissue consisting of fluid and edema, gallbladder inflammatory changes and gallstones. (Authors’ unpublished data).

Figure 4

Comparative diagram of Sensitivity for US, CT and MRI techniques

Figure 5

Comparative diagram of Sensitivity for US, CT and MRI techniques