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Robotic Lateral Pancreaticojejunostomy for Chronic Pancreatitis

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ACR Appropriateness Criteria® Chronic Pancreatitis.

, Ayushi Gupta¹, Victoria Chernyak²

¹Emory University School of Medicine, Atlanta, Georgia.

Journal of the American College of Radiology : JACR

|January 6, 2026

Summary

Chronic pancreatitis (CP) diagnosis relies on imaging like CT and MRI. Advanced techniques improve early detection of pancreatic changes and complications, guiding effective patient care.

Keywords:

AUC Acute on chronic pancreatitis Appropriate Use Criteria Appropriateness Criteria chronic pain chronic pancreatitis pancreatic calcifications pancreatic duct irregularity pancreatic fibrosis

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Area of Science:

Gastroenterology
Radiology
Medical Imaging

Background:

Chronic pancreatitis (CP) is a progressive pancreatic disease causing pain and insufficiency.
Acute inflammation on CP (ACP) worsens decline and morbidity.
Accurate diagnosis of CP and ACP is crucial for patient management.

Purpose of the Study:

To review the role of imaging in diagnosing and managing chronic pancreatitis (CP) and acute inflammation superimposed on CP (ACP).
To highlight the strengths of different imaging modalities for CP and ACP detection.
To emphasize the importance of evidence-based guidelines in clinical practice.

Main Methods:

Review of imaging techniques including CT, MRI with MRCP, and endoscopic ultrasound.
Discussion of the American College of Radiology Appropriateness Criteria methodology.
Inclusion of expert opinion where literature is limited.

Main Results:

CT excels in detecting calcifications and evaluating ACP.
MRI with MRCP is more sensitive for early ductal and parenchymal changes.
Secretin-stimulated MRCP enhances detection in early or mild disease.

Conclusions:

Early and accurate imaging is essential for effective CP patient care.
Imaging modalities like CT and MRI play vital roles in diagnosis, severity assessment, and complication detection.
Evidence-based guidelines and expert consensus inform appropriate imaging selection.