Usefulness of serum lipase for early diagnosis of post-endoscopic retrograde cholangiopancreatography pancreatitis

Table 1 Participant background

Characteristic	Value median [range] or n (%)
Age, yr	71 [6-98]
Sex
Male	496 (61.7)
Female	308 (38.3)
History of previous pancreatitis
Yes	31 (3.9)
No	773 (96.1)
History of previous PEP
Yes	6 (0.7)
No	798 (99.3)
Sphincter of Oddi dysfunction
Yes	3 (0.4)
No	801 (99.6)
Diagnosis
Benign	412 (51.2)
Malignancy	392 (48.8)
Indications for ERCP
Diagnostic	303 (37.7)
Therapeutic	501 (62.3)
Hyperlipasemia before ERCP
Yes	202 (25.1)
No	602 (74.9)
Hyperamylasemia before ERCP
Yes	97 (12.1)
No	707 (87.9)

ERCP: Endoscopic retrograde cholangiopancreatography; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 2 Incidence of post-endoscopic retrograde cholangiopancreatography pancreatitis and elevated serum pancreatic enzyme levels in the early and late stages after endoscopic retrograde cholangiopancreatography, n (%)

	Early stage after ERCP1	Late stage after ERCP2
PEP
Yes	40 (5.0)	38 (4.7)
No	764 (95.0)	766 (95.3)
Hyperlipasemia3
Yes	236 (29.4)	239 (29.7)
No	568 (70.6)	565 (70.3)
Hyperamylasemia3
Yes	104 (12.9)	138 (17.2)
No	700 (87.1)	666 (82.8)

¹Early stage is within 3 h after ERCP.

²Late stage is from 3 h after ERCP to the next morning.

³More than 3 times the standard value for the facility. ERCP: Endoscopic retrograde cholangiopancreatography; PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 3 Incidence and severity of post-endoscopic retrograde cholangiopancreatography pancreatitis among participants¹, n (%)

	Value
PEP	78 (9.7)
Mild	72 (9.0)
Moderate	5 (0.6)
Severe	1 (0.1)

¹Acute pancreatitis classification from the revised Atlanta classification[2]. PEP: Post-endoscopic retrograde cholangiopancreatography pancreatitis.

Table 4 The areas under the receiver operating characteristic curves and optimal cutoff values for s-Lipase and s-Amylase based on the presence/absence of post-endoscopic retrograde cholangiopancreatography pancreatitis in the early stage after endoscopic retrograde cholangiopancreatography

	s-Lip	s-Amy	P-value1
AUC (95%CI)	0.908 (0.880-0.940)	0.880 (0.846-0.915)	0.023
Optimal cutoff value (U/L)	342	171	―
Sensitivity	0.859	0.859	―
Specificity	0.867	0.763	―
Positive predictive value	0.405	0.277	―
Negative predictive value	0.981	0.979	―

¹P < 0.05, s-Lip vs s-Amy. AUC: Area under the curve; CI: Confidence interval; s-Lip, Serum lipase; s-Amy: Serum amylase.