The Predictivity of Serum Biochemical Markers in Acute Biliary Pancreatitis

Abstract

Background and Aim. There are no accurate methods of differentiating acute biliary pancreatitis. Obstructions of biliary ducts, idiopathic pancreatitis may be related with biliary origin which needs identification for acute treatment. We searched for the predictivity of biochemical markers in early acute biliary pancreatitis. Patients and Methods. Serum levels of AST (Aspartate Transaminase),ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), GGT (Gamma Glutamyl Transferase), total bilirubin, direct bilirubin, LDH (Lactate Dehydrogenase), amylase, lipase, CRP (C-Reactive Protein) and WBC (White Blood Cell) were measured in 157 patients with acute pancreatitis. Biliary and nonbiliary pancreatitis were differentiated by Magnetic Resonance Cholangiopancreatography (MRCP), Endoscopic Retrograde Cholangiopancreatography (ERCP), Intraoperative Cholangiopancreatography (IOC). Cut-off points of admission biochemical markers with sensitivity, specifity, positive predictive value and negative predictive value were determined after identification of significant variables. Receiver Operator Curves were plotted for each biochemical marker. Results. Serum Alkaline Phosphatase, total bilirubin, direct bilirubin, amylase and lipase levels were significantly higher in biliary pancreatitis with a positive predictive value of 80.8%, 83.9%, 81.6%, 78.8%, 79.7%. Conclusion. Increased Alkaline Phosphatase,total bilirubin, direct bilirubin, amylase and lipase levels may be used in prediction of biliary pancreatitis.

The comparison between combination of pancreatic stent and nsaid with nsaid alone in preventing post ERCP pancreatitis

“…30 In addition to PEP, overall complications of ERCP were 1.52times higher in women. 29 In contrast, there was no significant association between age or sex and PEP in our study, even slightly higher risk of PEP, but not significant, was observed. Interestingly, lack of association between age and sex and the risk of PEP also has been observed by Cheng et al 31 In the searching for patient-related risk factors, previous evidences has reported that post-ERCP elevation of inflammatory and biochemical markers could be a potential predictors of PEP.…”

“…In relation to patient-related risk factors, previous studies have discussed that being female and younger ages were significant risk factors for PEP. 29 The impact of age seems to be related to protective effect of progressive decline in pancreatic exocrine function by aging. 30 In addition to PEP, overall complications of ERCP were 1.52times higher in women.…”

“…34 However, later reports have not mentioned these variables as significant risk factors of PEP. 29 Although they alternatively added other risk factors, such as cannulation time and periampullary diverticulum, as significantly related to pancreatitis. 29 Our observation suggested that balloon dilation of S.O.…”

The Etiologic Evaluation of Acute Pancreatitis in a General Hospital of Seoul-Gyeonggi Province in Korea

“…Here, in idiopathic AP, we defined the elevation of serum alkaline phosphatase (ALP) and increased alanine aminotransferase (ALT) (≥3 times the upper limit of normal) as findings suggestive of microlithiasis. [16][17][18][19][20] …”

“…27,28 Several studies have shown that elevated ALP is a common marker for diagnosing gallstone-induced pancreatitis. 16,18 Several recent reports proposed that the ALT level might be a marker for early recognition of a gallstone etiology in patients with AP. 17,19,20,29 In particular, increased ALT, ≥3-fold the normal level, highly suggests microlithiasis.…”