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©2007 Baishideng Publishing Group Co.
World J Gastroenterol. Jul 28, 2007; 13(28): 3855-3860
Published online Jul 28, 2007. doi: 10.3748/wjg.v13.i28.3855
Published online Jul 28, 2007. doi: 10.3748/wjg.v13.i28.3855
Table 1 Characteristics and diagnosis of the patients
Parameters | Results |
No. of patients (n) | 1291 |
Mean age (yr, range) | 64 (12-96) |
Male:female | 738:553 |
Pancreatic duct opacification | 875 (68%) |
Difficult bile duct cannulation | 107 (8%) |
Intraductal ultrasonography | 266 (20) |
Biliary sphincterotomy | 270 (20%) |
Biliary stent placement | 60 (112%) |
Papillary balloon dilatation | 50 (3.8%) |
Cytology of the bile/pancreatic juice | 53 (4.1%) |
Biopsy of the bile/pancreatic duct | 78 (6.0%) |
Gallbladder stone | 488 (38%) |
Choledocholithiasis | 313 (24%) |
Cholangiocarcinoma | 75 (6%) |
Pancreatic cancer | 73 (6%) |
Intraductal papillary mucinous neoplasm | 63 (4%) |
Ampullary cancer | 23 (2%) |
Pancreaticobiliary maljunction | 20 (2%) |
Table 2 Risk factors of post-ERCP pancreatitis
Pancreatitis (+)(n = 47) | Pancreatitis (-)(n = 1244) | P | |
Male:female | 31:16 | 707:537 | 0.21 |
Pancreatic duct opacification | 37 (78%) | 838 (67%) | 0.10 |
Difficult bile duct cannulation | 7 (14%) | 100 (8%) | 0.09 |
Intraductal ultrasonography | 13 (28%) | 253 (20%) | 0.22 |
Biliary sphincterotomy | 12 (26%) | 258 (20%) | 0.42 |
Biliary stent placement | 10 (21%) | 150 (12%) | 0.06 |
Biliary stent placement without sphx1 | 5 (10%) | 42 (3%) | 0.026 |
Papillary balloon dilatation | 4 (8%) | 46 (4%) | 0.20 |
Cytology of the bile/pancreatic juice | 4 (8%) | 49 (3.9%) | 0.12 |
Biopsy of the bile/pancreatic duct | 2 (4%) | 76 (6%) | 0.60 |
Gallbladder stone | 15 (32%) | 433 (34%) | 0.68 |
Choledocholithiasis | 15 (32%) | 298 (24%) | 0.21 |
Cholangiocarcinoma | 5 (10%) | 70 (6%) | 0.14 |
Pancreatic cancer | 3 (6%) | 70 (6%) | 0.92 |
Intraductal papillary mucinous neoplasm | 5 (10%) | 58 (4%) | 0.12 |
Ampullary cancer | 0 | 23 (2%) | 0.70 |
Pancreaticobiliary maljunction | 0 | 20 (2%) | 0.78 |
Table 3 Correlation between the change in serum amylase level and post-ERCP pancreatitis
Serum amylase values | Pancreatitis rate | ||||
3 h | 6 h | 24 h | |||
> 10 times | 39% (12/31) | 21% b | 44% (26/59) | 59% (27/46) | 49% d |
5-10 times | 31% (14/45) | 18% (9/49) | 38% (14/37) | ||
3-5 times | 20% (10/49) | 8% (5/57) | 6% (3/47) | 0.5% d | |
2-3 times | 5% (3/63) | 5% (3/61) | 6% (3/49) | ||
1-2 times | 1% (3/217) | 0.7% b | 1% (2/196) | 0% (0/206) | |
≤normal | 1% (5/886) | 1% (2/869) | 0% (0/906) |
Table 4 Serum amylase level as a predictive factor of post-ERCP pancreatitis
Time after ERCP | Amylase level | Sensitivity (%) | PPV (%) |
3 h | > Upper normal limit | 89 | 10 |
> 2 times | 83 | 21 | |
> 3 times | 77 | 29 | |
> 5 times | 55 | 34 | |
> 10 times | 26 | 39 | |
6h | > Upper normal limit | 96 | 11 |
> 2 times | 91 | 19 | |
> 3 times | 85 | 24 | |
> 5 times | 74 | 32 | |
> 10 times | 55 | 44 |
- Citation: Ito K, Fujita N, Noda Y, Kobayashi G, Horaguchi J, Takasawa O, Obana T. Relationship between post-ERCP pancreatitis and the change of serum amylase level after the procedure. World J Gastroenterol 2007; 13(28): 3855-3860
- URL: https://www.wjgnet.com/1007-9327/full/v13/i28/3855.htm
- DOI: https://dx.doi.org/10.3748/wjg.v13.i28.3855