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Prediction of Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis Using 4-Hour Post-Endoscopic Retrograde Cholangiopancreatography Serum Amylase and Lipase Levels
Journal of Korean Medical Science ; : 1814-1819, 2017.
Artigo em Inglês | WPRIM | ID: wpr-225691
ABSTRACT
Early post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) prediction may allow safe same-day outpatients discharge after ERCP and earlier proper management. This study aimed to assess the usefulness of the 4-hour post-ERCP serum amylase and lipase levels for PEP early prediction and to investigate predictive cut-off values for 4-hour post-ERCP serum amylase and lipase levels for safe discharge and urgent initiation of resuscitation. The data of 516 consecutive patients with native papilla who underwent ERCP between January 2013 and August 2014 were retrospectively reviewed. Serum amylase and lipase levels were measured before, and 4 and 24 hours after ERCP. PEP occurred in 16 (3.1%) patients. The receiver-operator characteristic curve for 4-hour post-ERCP serum amylase and lipase levels showed that the areas under the curve were 0.919 and 0.933, respectively, demonstrating good test performances as predictors for PEP (both P values 1.5 × the upper limit of reference (ULR) was found useful for PEP exclusion with a sensitivity of 93.8%, while 4 × ULR was found useful to guide preventive therapy with the best specificity of 93.2%. Similarly, the lipase level 2 × ULR showed best sensitivity, while 8 × ULR had the best specificity. Logistic regression analysis showed that 4-hour post-ERCP amylase level > 4 × ULR, lipase level > 8 × ULR, precut sphincterotomy, and pancreatic sphincterotomy were significant predictors for PEP. In conclusion, 4-hour post-ERCP amylase and lipase levels are useful early predictors of PEP that can ensure safe discharge or prompt resuscitation after ERCP.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Pacientes Ambulatoriais / Pancreatite / Ressuscitação / Modelos Logísticos / Estudos Retrospectivos / Sensibilidade e Especificidade / Colangiopancreatografia Retrógrada Endoscópica / Amilases / Lipase Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Humanos Idioma: Inglês Revista: Journal of Korean Medical Science Ano de publicação: 2017 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Pacientes Ambulatoriais / Pancreatite / Ressuscitação / Modelos Logísticos / Estudos Retrospectivos / Sensibilidade e Especificidade / Colangiopancreatografia Retrógrada Endoscópica / Amilases / Lipase Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Humanos Idioma: Inglês Revista: Journal of Korean Medical Science Ano de publicação: 2017 Tipo de documento: Artigo