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

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

Research output: Contribution to journalArticle

86 Scopus citations

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 (US)
Pages (from-to)1553-1557
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume91
Issue number8
StatePublished - Aug 1 1996

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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