The value of elastase evaluation in comparison with amylase andlipase in prediction and diagnosis of post-ERCP pancreatitis

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Annals of Gastroenterology
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The value of elastase evaluation in comparison with amylase andlipase in prediction and diagnosis of post-ERCP pancreatitis (EN)

Kokozidis G, Kinigopoulou P., Kapetanos D., Paikos D., Papaioannou A., Progia E., Kitis G., .

Pancreatitis is the most common of the serious complications of ERCP, with rates between 2 and 40%. The aim of this study was to evaluate the significance of serum levels of amylase, lipase and elastase after ERCP, in the prediction and diagnosis of pancreatitis. Patients: Forty three consecutive patients underwent ERCP for various indications. Methods: Serum samples were taken before, one hour and six hours after the procedure. Amylase was evaluated with enzymatic colourimetric test (Olympus, normal2N) the first hour and 26 (60%) the sixth. Twenty seven (62%) had serum lipase elevation (>2N) the first hour and 30 (70%) the sixth. Four (9%) had increased elastase (>2N) the first hour and 2 (4%) the sixth. The only enzyme that was significantly elevated in the patients who developed pancreatitis compared to those who did not, was serum elastase at one hour post-ERCP (p=0,025). In the first hour, sensitivity for amylase, lipase and elastase was 50%, 100% and 100% respectively, specificity 60%, 40% and 95%,positive predictive value (PPV) 5%, 7% and 50% and negative predictive value (NPV) 96%, 100% and 100%. In the sixth hour sensitivity was 100%, 100% and 100%, specificity 40%, 30% and 98%, PPV 4%, 3% and 50% and NPV 100%, 100% and 100% respectively. Conclusions: Although serum amylase and lipase evaluation are good methods to exclude the diagnosis of pancreatitis, they do not assist in prediction and documentation of diagnosis. In contrast, serum elastase evaluation is more reliable in prediction and diagnosis of post-ERCP pancreatitis. Key words: ERCP, pancreatitis, amylase, lipase, elastase (EN)


Αγγλική γλώσσα


Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 13, No 2 (2000) (EN)

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