Twenty-Four-Hour Serum Amylase Predicting Pancreatic Reaction After Endoscopic Sphincterotomy

Testoni, Pier Alberto; Caporuscio, S.; Bagnolo, F.; Lella, F.

doi:10.1055/s-1999-13660

Cited by 37 publications

(36 citation statements)

References 16 publications

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“…Hyperamylasemia was defined when there was an increase in serum amylase above the upper normal value (220 IU/L); leukocytosis was defined when the white cell count was >10,000 cells/ mm 3 [2,27]. Pancreatic-like pain was defined as a persistent epigastric pain, often radiating to the back [13].…”

Section: Methodsmentioning

confidence: 99%

Use of the laparoscopic–endoscopic approach, the so-called “rendezvous” technique, in cholecystocholedocholithiasis

Lella¹,

Bagnolo²,

Rebuffat

et al. 2006

Surg Endosc

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101

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Section: Methodsmentioning

confidence: 99%

Use of the laparoscopic–endoscopic approach, the so-called “rendezvous” technique, in cholecystocholedocholithiasis

Lella¹,

Bagnolo²,

Rebuffat

et al. 2006

Surg Endosc

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101

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“…Bedside assessment alone has been shown to be suboptimal in assessing for development of pancreatitis [78] . A combined clinical and laboratory assessment has been shown to be most sensitive and specific [76][77][78][79][80] . Ideally, a test is needed which is readily available, inexpensive, with rapid results available, and patients are separated into patients with no PEP (for early discharge) and those with PEP (needing hospitalization).…”

Section: Contrast Mediamentioning

confidence: 99%

“…Serum amylase below 276 IU/L (normal, 40-125 IU/L), and serum lipase below 1000 IU/L (normal, 4-24 IU/L) at 2 h after ERCP were highly predictive in ruling out pancreatitis with negative predictive values of 0.97 and 0.98 respectively. Testoni et al [79] evaluated 409 patients who underwent endoscopic sphincterotomy and measured serum amylase levels. Post-procedural hyperamylasemia (> 220 IU/L) occurred in 192 of the 409 patients (46.9%).…”

Section: Category 1: Pancreatic Enzymes As Markers Of Pancreatic Injurymentioning

confidence: 99%

Pancreatits after endoscopic retrograde cholangio-pancreatography

Aziz

Lehman

2007

WJG

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Pancreatitis is the most common complication after endoscopic retrograde cholangio-pancreatography (ERCP); the reported incidence of this complication varies from less than 1% to 40%, but a rate of 4%-8% is reported in most prospective studies involving nonselected patients. Differences in criteria for defining pancreatitis, methods of data collection, and patient populations (i.e. number of high-risk patients included in the published series) are factors that are likely to affect the varying rates of post-ERCP pancreatitis. The severity of post-ERCP pancreatitis (PEP) can range from a minor inconvenience with one or two days of added hospitalization with full recovery to a devastating illness with pancreatic necrosis, multiorgan failure, permanent disability, and even death. Although, most episodes of PEP are mild (about 90%), a small percentage of patients (about 10%) develop moderate or severe pancreatitis. In the past, PEP was often viewed as an unpredictable and unavoidable complication, with no realistic strategy for its avoidance. New data have aided in stratification of patients into PEP risk categories and new measures have been introduced to decrease the risk of PEP. As most ERCPs are performed on an outpatient basis, the majority of patients will not develop PEP and can be discharged. Alternatively, early detection of those patients who will go on to develop PEP can guide decisions regarding hospital admission and aggressive management. In the last decade, great efforts have been addressed toward prevention of this complication. Points of emphasis have included technical measures, pharmacological prophylaxis, and patient selection. This review provides a comprehensive, evidence-based assessment of published data on PEP and current suggestions for its avoidance.© 2007 The WJG Press. All rights reserved.Key words: Endoscopic retrograde cholangiopancreatography; Post-ERCP pancreatitis Abdel Aziz AM, Lehman GA. Pacreatitis after endoscopic r e t r o g r a d e c h o l a n g i o -p a n c r e a t o g r a p h y . W o r l d J

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“…Although clinical symptoms are reliable indicators of pancreatic inflammation, in a reported study approximately 30% of patients who developed post‐ERCP pancreatitis had no clinical signs at 2 h after the procedure 31 . Utility of the measurement of serum amylase and lipase for early diagnosis of pancreatitis has been reported 31–35 . Testoni et al .…”

Section: Complications Of Ercpmentioning

confidence: 99%

Risk Management of Endoscopic Sphincterotomy for Choledocholithiasis

Ito

Fujita

Noda

et al. 2007

Digestive Endoscopy

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Endoscopic retrograde cholangiopancreatography (ERCP) is accepted as a safe, direct technique for evaluating pancreatobiliary diseases. Since the introduction of endoscopic sphincterotomy (EST), ERCP has evolved from a diagnostic procedure to a therapeutic one. ERCP with EST and stone removal is a valuable therapeutic modality in choledocholithiasis. Herein are reviewed the complications of EST in cases of choledocholithiasis along with a discussion of the risk management of this particular procedure. Pancreatitis is the most common ERCP‐related complication. Hemorrhage is primarily a complication related to sphincterotomy. Other complications include perforation, cholangitis, cholecystitis, and sedation‐related cardiopulmonary complications. Endoscopists who perform ERCP should have appropriate training and be knowledgeable of such complications.

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Twenty-Four-Hour Serum Amylase Predicting Pancreatic Reaction After Endoscopic Sphincterotomy

Abstract: Serum amylase assessment four hours after ES is a reliable, cost-effective follow-up and minimizes the likelihood of underestimating the risk of post-procedure pancreatic reaction. It should be recommended particularly in out-patients and when pancreatic duct opacification has occurred.

Cited by 37 publications

References 16 publications

Use of the laparoscopic–endoscopic approach, the so-called “rendezvous” technique, in cholecystocholedocholithiasis

Use of the laparoscopic–endoscopic approach, the so-called “rendezvous” technique, in cholecystocholedocholithiasis

Pancreatits after endoscopic retrograde cholangio-pancreatography

Risk Management of Endoscopic Sphincterotomy for Choledocholithiasis

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