Endoscopic ultrasonography as an effective tool for predicting complications of biliary pancreatitis

Endoscopic ultrasonography (EUS) is a promising diagnostic method for identifying complications associated with acute biliary pancreatitis (ABP); however, its efficacy and clinical significance require further investigation. Objective. To evaluate the diagnostic effectiveness of EUS in acute biliary pancreatitis. Material and methods. A retrospective analysis included 92 patients with confirmed ABP admitted to V.M. Buyanov City Clinical Hospital (Moscow) between 2017 and 2022. All patients underwent EUS within the first 7 days after symptom onset. Patients were divided into two groups: the main group (n=15) with severe ABP and the control group (n=77) with mild and moderately severe ABP. A comparative analysis of endosonographic signs was performed, followed by ROC analysis to assess the diagnostic accuracy of EUS. Results. Statistically significant predictors of severe ABP included hypoechoic necrotic foci (OR=4.4; 95% CI 1.4—14.3), infiltration of peripancreatic fat (OR=5.7; 95% CI 1.2—27.0), and fluid collections in the retroperitoneal space (OR=14.4; 95% CI 1.8—114.7). The sensitivity of EUS in diagnosing necrotizing pancreatitis was 83.8%, specificity was 60%, and accuracy was 71.9%. Diagnostic efficacy of EUS was statistically comparable to computed tomography (p>0.05). Conclusion. EUS is an effective and safe diagnostic modality for ABP, comparable in informativeness to CT, and can be utilized for early detection of severe disease forms and optimization of therapeutic strategies.