Endoscopic ultrasonography in acute biliary pancreatitis

EUS appears to be a very accurate test for diagnosing CBD stones in a relatively large number of studies using a variety of methodologic approaches, mostly in patients with a moderate-to-high suspicion of gallstones, however. Whether these results can be transferred to patient groups with low stone prevalence, and to other examiners outside the centers of excellence, is not fully known. In the setting of acute pancreatitis, the same seems to be true, but the evidence is based on only two studies, each with a rather small number of patients. In our opinion, the biggest competitor for EUS is MRCP, and further comparative studies will shed some more light on the relative value and cost-effectiveness of both tests in the setting of acute biliary pancreatitis.