Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study
Department of Surgery, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
Frank P Vleggaar
36 Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands
Paul Fockens
Department of Gastroenterology & Hepatology, Amsterdam Gastroenterology and Metabolism, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
Marco J Bruno
Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
Hjalmar C van Santvoort
1 Department of Surgery, St Antonius Hospital Location, Utrecht, Netherlands
Jeanin E van Hooft
Department of Gastroenterology and Hepatology, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands
Menno A Brink
Department of Gastroenterology and Hepatology, Meander MC, Amersfoort, Utrecht, The Netherlands
Jan-Werner Poley
14 Department of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, Netherlands
Robert C Verdonk
27 Department of Gastroenterology and Hepatology, St Antonius Hospital Location, Utrecht, Netherlands
Hendrik M van Dullemen
Department of Gastroenterology, Universtiy of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
Liesbeth M Kager
12 Department of Gastroenterology & Hepatology, Noordwest Ziekenhuisgroep, Alkmaar, Netherlands
Devica S Umans
Research and Development, Saint Antonius Hospital, Nieuwegein, Utrecht, The Netherlands
Hester C Timmerhuis
1 Department of Surgery, St Antonius Hospital Location, Utrecht, Netherlands
Nora D Hallensleben
Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
Stefan A Bouwense
Department of Surgery, Maastricht UMC+, Maastricht, Limburg, The Netherlands
Marie-Paule GF Anten
Department of Gastroenterology and Hepatology, Franciscus Gasthuis en Vlietland, Rotterdam, Zuid-Holland, The Netherlands
Abha Bhalla
Department of Gastroenterology and Hepatology, HagaZiekenhuis, Den Haag, Zuid-Holland, The Netherlands
Rina A Bijlsma
Department of Gastroenterology and Hepatology, Martini Ziekenhuis, Groningen, Groningen, The Netherlands
Lieke Hol
Department of Gastroenterology and Hepatology, Maasstad Hospital, Rotterdam, Zuid-Holland, The Netherlands
Wouter L Curvers
Department of Gastroenterology and Hepatology, Catharina Hospital, Eindhoven, North Brabant, The Netherlands
Brechje C van Eijck
Department of Gastroenterology and Hepatology, Spaarne Gasthuis, Haarlem, Noord-Holland, The Netherlands
G Willemien Erkelens
Department of Gastroenterology and Hepatology, Gelre Ziekenhuizen, Apeldoorn, Gelderland, The Netherlands
Erwin J M van Geenen
Department of Gastroenterology and Hepatology, Radboud university medical center, Nijmegen, the Netherlands
Wouter L Hazen
14 Department of Gastroenterology and Hepatology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
Chantal V Hoge
Department of Gastroenterology and Hepatology, Maastricht UMC+, Maastricht, Limburg, The Netherlands
Akin Inderson
Department of Gastroenterology and Hepatology, LUMC, Leiden, Zuid-Holland, The Netherlands
Sjoerd D Kuiken
Department of Gastroenterology and Hepatology, OLVG, Amsterdam, Noord-Holland, The Netherlands
Lars E Perk
Department of Gastroenterology and Hepatology, Medisch Centrum Haaglanden, Den Haag, Zuid-Holland, The Netherlands
Rutger Quispel
15 Department of Gastroenterology and Hepatology, Reinier de Graaf Gasthuis, Delft, Netherlands
Tessa EH Römkens
Department of Gastroenteroloy and Hepatology, Jeroen Bosch Hospital, `s-Hertogenbosch, Noord-Brabant, Netherlands
Adriaan CITL Tan
Department of Gastroenterology and Hepatology, Canisius Wilhelmina Hospital, Nijmegen, Gelderland, The Netherlands
Annemieke Y Thijssen
Department of Gastroenterology and Hepatology, Albert Schweitzer Ziekenhuis, Dordrecht, Zuid-Holland, The Netherlands
Niels G Venneman
22 Department of Gastroenterology and Hepatology, Medical Spectrum Twente, Enschede, Netherlands
Annet MCJ Voorburg
Department of Gastroenterology and Hepatology, Diakonessenhuis Utrecht Zeist Doorn, Utrecht, Utrecht, The Netherlands
Roy LJ van Wanrooij
Department of Gastroenterology and Hepatology, Amsterdam University Medical Centres, Amsterdam, The Netherlands
Ben J Witteman
Department of Gastroenterology, Gelderse Vallei Hospital, Ede, The Netherlands
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.Trial registration number Netherlands Trial Registry (NL7066). Prospectively registered.
