Early recognition of post-ERCP pancreatitis by clinical assessment and serum pancreatic enzymes

Klaus Gottlieb, Stuart Sherman, Jim Pezzi, Edward Esber, Glen Lehman

Research output: Contribution to journalArticle

84 Citations (Scopus)

Abstract

Background: This study evaluates the relative value of clinical assessment and serum pancreatic enzymes in the discharge management of outpatients undergoing ERCP. Methods: Two hundred thirty-one patients who underwent ERCP had a detailed clinical assessment performed 2 h after the procedure and blood drawn for amylase and lipase. Results: One-third of the patients who later developed pancreatitis had no pain 2 h after the end of the procedure, whereas an equal number who had no pancreatitis did complain of pain. Values below 276 U/L for amylase and 1000 U/L for lipase were useful in ruling out pancreatitis with negative predictive values of 0.97 and 0.98, respectively. Based on the data of this study a discharge algorithm for outpatients undergoing ERCP is proposed. Conclusions: In contrast to clinical assessment, which is unreliable, it is possible to stratify patients according to their risk of developing pancreatitis according to their 2-h serum amylase and lipase values. This helps to rationalize the discharge management of outpatients undergoing ERCP at a time when careful utilization of resources, especially the avoidance of unnecessary hospital admissions, becomes increasingly more important.

Original languageEnglish
Pages (from-to)1553-1557
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume91
Issue number8
StatePublished - Aug 1996

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Endoscopic Retrograde Cholangiopancreatography
Pancreatitis
Amylases
Lipase
Outpatients
Enzymes
Serum
Pain

ASJC Scopus subject areas

  • Gastroenterology

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Early recognition of post-ERCP pancreatitis by clinical assessment and serum pancreatic enzymes. / Gottlieb, Klaus; Sherman, Stuart; Pezzi, Jim; Esber, Edward; Lehman, Glen.

In: American Journal of Gastroenterology, Vol. 91, No. 8, 08.1996, p. 1553-1557.

Research output: Contribution to journalArticle

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