SynthesisGut2023
Consensus definition of sludge and microlithiasis as a possible cause of pancreatitis.
Synthesis in Gut, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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Who cites it
13 citing papers in PubMed, 37 citations in OpenAlex.
- Clinical characteristics, etiology, and outcomes of acute pancreatitis at a tertiary referral center in Latvia: a retrospective cohort study.BMC gastroenterology · 2026Article
- Microlithiasis-Induced Acute Papillitis Triggers Acute Pancreatitis: Where Do We Go From Here?United European gastroenterology journal · 2026Article
- Intrabiliary ultrasound applied to endoscopic extraction of choledochal stones.Asian biomedicine : research, reviews and news · 2026Article
- Differentiation of Gallbladder Adenomyomatosis and Polyps in a Western Cohort: Prevalence, Ultrasound Characteristics, and Diagnostic Challenges.JGH open : an open access journal of gastroenterology and hepatology · 2026Article
- Functional fatty acid-based dietary therapy as a new strategy for small gallstone expulsion: study protocol for a prospective, single-center, double-blind, randomized controlled trial.Frontiers in nutrition · 2026Article
- BILIARY SLUDGE-ASSOCIATED ACUTE PANCREATITIS: CLINICAL SPECTRUM, DIAGNOSIS, AND MANAGEMENT.Arquivos de gastroenterologia · 2026Review
- Numbers Matter: Influence of Pancreatitis on Life Expectancy.Digestive diseases and sciences · 2025Article
- Endoscopic management of infected necrotizing pancreatitis: Advancing through standardization.World journal of gastroenterology · 2025Review
- Dietary functional fatty acids and gallstone elimination.QJM : monthly journal of the Association of Physicians · 2025Article
- Article
- Pathophysiology of severe gallstone pancreatitis: A new paradigm.World journal of gastroenterology · 2024Article
- Idiopathic acute pancreatitis (IAP)-a review of the literature and algorithm proposed for the diagnostic work-up of IAP.Translational gastroenterology and hepatology · 2024Review
- Natural Course of Common Bile Duct Microlithiasis.Digestive diseases and sciences · 2023Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn up to 20% of patients, the aetiology of acute pancreatitis (AP) remains elusive and is thus called idiopathic. On more detailed review these cases can often be explained through biliary disease and are amenable to treatment. Findings range from biliary sludge to microlithiasis but their definitions remain fluid and controversial.
designA systematic literature review (1682 reports, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) analysed definitions of biliary sludge and microlithiasis, followed by an online international expert survey (30 endoscopic ultrasound/hepatobiliary and pancreatic experts; 36 items) which led to definitions of both. These were consented by Delphi voting and clinically evaluated in a retrospective cohort of patients with presumed biliary pancreatitis.
resultsIn 13% of original articles and 19.2% of reviews, microlithiasis and biliary sludge were used synonymously. In the survey, 41.7% of experts described the term 'sludge' and 'microlithiasis' as identical findings. As a consequence, three definitions were proposed, agreed on and confirmed by voting to distinctly discriminate between biliary sludge (hyperechoic material without acoustic shadowing) and microlithiasis (echorich calculi of ≤5 mm with acoustic shadowing) as opposed to larger biliary stones, both for location in gallbladder and bile ducts. In an initial attempt to investigate the clinical relevance in a retrospective analysis in 177 confirmed cases in our hospital, there was no difference in severity of AP if caused by sludge, microlithiasis or stones.
conclusionWe propose a consensus definition for the localisation, ultrasound morphology and diameter of biliary sludge and microlithiasis as distinct entities. Interestingly, severity of biliary AP was not dependent on the size of concrements warranting prospective randomised studies which treatment options are adequate to prevent recurrence.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.