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Serum lipase as a biomarker for early prediction and diagnosis of post-endoscopic retrograde cholangiopancreatography pancreatitis

Irish Journal of Medical Science (1971 -) volume 189, pages 163–170 (2020)Cite this article

Abstract

Background

Lipase is one of the diagnostic criteria for acute pancreatitis; however, the value of serum lipase in the early prediction and diagnosis for post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis remains controversial.

Aims

We evaluate the 3-h post-ERCP serum amylase and lipase activities for early prediction of postoperative pancreatitis (PEP) and compare the 24-h post-ERCP serum amylase and lipase activities in the diagnosis of PEP.

Methods

Clinical information of patients who underwent ERCP from January 2017 to December 2018 at our hospital were retrospectively reviewed. Receiver operating characteristic (ROC) curves were performed for 3-h and 24-h post-ERCP serum amylase and lipase activities to evaluate predictive and diagnostic values, respectively.

Results

A total of 498 cases with ERCP were finally enrolled, in which 36 cases of PEP were confirmed. ROC curves for 3-h post-ERCP amylase and lipase activities depicted areas under the curve (AUCs) of 0.88 (P < 0.001, 95% confidence intervals [CI] 0.82–0.93) and 0.90 (P < 0.001, 95% CI 0.86–0.93), respectively. The difference showed no significance using Z test (Z = 0.69, P > 0.05). AUCs for 24-h amylase and lipase activities were 0.83 (P < 0.001, 95% CI 0.77–0.89) and 0.94 (P < 0.001, 95% CI 0.90–0.99), respectively, and the difference was significant (Z = 3.04, P < 0.05).

Conclusions

For early prediction of PEP, 3-h post-ERCP serum lipase activity is at least as good as that of amylase. For diagnosis of PEP, 24-h post-ERCP serum lipase is a much better indicator than that of amylase. Together, this study suggests that serum lipase should be given priority in the early prediction and diagnosis of PEP.

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Acknowledgments

We thank the patients involved in this study and the support from the Department of Gastroenterology, Renmin Hospital of Wuhan University. We thank many online databases and resources for providing data and tools.

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Authors and Affiliations

  1. Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China

    Yu Zhang, Xiaoling Ye, Xinyue Wan & Tao Deng

  2. Hubei Key Laboratory of Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China

    Yu Zhang, Xiaoling Ye, Xinyue Wan & Tao Deng

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Correspondence to Tao Deng.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Zhang, Y., Ye, X., Wan, X. et al. Serum lipase as a biomarker for early prediction and diagnosis of post-endoscopic retrograde cholangiopancreatography pancreatitis. Ir J Med Sci 189, 163–170 (2020). https://doi.org/10.1007/s11845-019-02089-2

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