Combination of two-hour post-endoscopic retrograde cholangiopancreatography amylase levels and cannulation times is useful for predicting post-endoscopic retrograde cholangiopancreatography pancreatitis

Abstract

AIMTo estimate the efficacy of 2 h post-endoscopic retrograde cholangiopancreatography (ERCP) serum amylase levels and other factors for predicting post-ERCP pancreatitis.METHODSThis was a retrospective, single-center cohort study of consecutive patients who underwent ERCP from January 2010 to December 2013. Serum amylase levels were measured 2 h post-procedure, and patient- and procedure-related pancreatitis (PEP) risk factors were analyzed using a logistic model.RESULTSA total of 1520 cases (average age 72 ± 12 years, 60% male) were initially enrolled in this study, and 1403 cases (725 patients) were ultimately analyzed after the exclusion of 117 cases. Fifty-five of these cases developed PEP. We established a 2 h serum amylase cutoff level of two times the upper limit of normal for predicting PEP. Multivariate analysis revealed that a cannulation time of more than 13 min [odds ratio (OR) 2.28, 95%CI: 1.132-4.651, P = 0.0210] and 2 h amylase levels greater than the cutoff level (OR = 24.1, 95%CI: 11.56-57.13, P < 0.0001) were significant predictive factors for PEP. Forty-seven of the 55 patients who developed PEP exhibited 2 h amylase levels greater than the cutoff level (85%), and six of the remaining eight patients who developed PEP (75%) required longer cannulation times. Only 2 of the 1403 patients (0.14%) who developed PEP did not exhibit concerning 2 h amylase levels or require longer cannulation times.CONCLUSIONThese findings indicate that the combination of 2 h post-ERCP serum amylase levels and cannulation times represents a valuable marker for identifying patients at high risk for PEP.

Radiation exposure dose and influencing factors during endoscopic retrograde cholangiopancreatography

“…1239). As a quality indicator for ERCP at our hospital, we have reported that the rate of post-ERCP pancreatitis was 3.9% (95% confidence interval: 3.02–5.07%) [ 17 ]. All the procedures were performed using wire-loaded cannulation method, which includes both contrast method and wire-guided method.…”

Early prediction of post-ERCP pancreatitis by post-procedure amylase and lipase levels: A systematic review and meta-analysis

“…After the removal of duplicates, 241 studies were screened. Of these, 179 were excluded, and full texts of 62 articles were reviewed that ultimately led to 18 studies that met the inclusion criteria 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 ( Supplemental Fig. 1 ).…”

“…▶ 62 articles were reviewed that ultimately led to 18 studies that met the inclusion criteria [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] (Supplemental Fig. 1).…”

Comparison of double-layer large-diameter and conventional small-diameter plastic stents for preoperative biliary drainage in resectable distal malignant biliary obstruction

“…1239), trainees or experts performed ERCP to control cholangitis or jaundice caused by suspected MBO; trainees were assisted by experts as needed to avoid complications and to ensure procedural quality when performing ERCP using a duodenoscope (JF260 V or TJF-260 V: Olympus Optical Co. Tokyo, Japan). As a quality indicator for ERCP, we, including trainees at our hospital, have reported a post-ERCP pancreatitis rate of 3.9% (95% confidence interval 3.02-5.07%) 7 . We did not use SEMSs for preoperative biliary drainage of MBO.…”