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

• 作者: Akiyoshi Shimoda Aya Sugimoto Hiromi Shimakoshi Kaori Mukai Kei Takahashi Koji Fukui Masami Inada Masashi Yamamoto Sachiko Nakajima Shiro Hayashi Takahiro Amano Tokuhiro Matsubara Tsutomu Nishida
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: Serum AMYLASE LEVELS CANNULATION time Post-endoscopic retrograde CHOLANGIOPANCREATOGRAPHY PANCREATITIS Predictor
• 年，卷（期）: 2016,（20）
• 页码范围: 777-784
• 页数: 8页
• 分类号: R

摘要

AIMTo estimate the efficacy of 2 h post-endoscopic etrograde cholangiopancreatography (ERCP) serum mylase levels and other factors for predicting post-ERCP pancreatitis.METHODS his was a etrospective, single-center cohort study f 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. RESULTS A total of 1520 cases (average age 72 ± 12 years, 60% male) were initially enrolled in this study, and 1403cases (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 2h 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.CONCLUSION These 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.