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4시간 후 혈청 아밀라아제와 리파아제 농도를 이용한 내시경 역행성 췌담도 조영술 이후 췌장염 발생의 예측
- Alternative Title
- Prediction of Post-ERCP Pancreatitis
- Author(s)
- Lee, Yeon Kyung
- Alternative Author(s)
- Yeon Kyung Lee
- Advisor
- 김진홍
- Department
- 일반대학원 의학과
- Publisher
- The Graduate School, Ajou University
- Publication Year
- 2015-08
- Language
- eng
- Keyword
- 급성췌장염; 내시경 역행성 췌담도 조영술; 고아밀라아제혈증
- Alternative Abstract
- Background & Aims : Acute pancreatitis is the most common, serious complication of endoscopic retrograde cholangiopancreatography (ERCP). Early prediction of post-ERCP pancreatitis (PEP) could enable earlier safe discharge of patients on the same day after ERCP. This study investigated a predictive cut-off value of 4-hour post-ERCP serum amylase and lipase levels for PEP. Methods : We retrospectively evaluated patients who underwent ERCP procedures and testing for serum amylase and lipase 4-hours after ERCP and the next morning at Ajou Medical Center from January 2012 to August 2013. We studied; patient demographics, procedure reasons, pancreatogram performance, and serum amylase and lipase levels. Results : PEP occurred in 16 (3.1%) patients after 516 ERCP procedures. Its severity was mild in 4 (25%), moderate in 9 (56.3%), and severe in 3 (18.8%). Mean 4-hour amylase level was significantly higher in patients with PEP; than in those without (965 U/L vs. 158 U/L, P = .001). No statistically significant differences occurred in age, sex, and procedure reasons between both groups. Sensitivity, specificity and negative predictive value (NPV) of 4-hour post-ERCP amylase level with a cut-off value of 2.5x upper limit of reference (ULR) (290 U/L) were 39.1%, 98.5% and 97.2%, respectively; with a cut-off value of 8× ULR (480 U/L), they were 60.0%, 97.5% and 99.6%. The patient group undergoing pancreatogram had a high incidence of PEP; but no significant difference in 4-hour post-ERCP serum amylase and lipase, compared with its counterpart. Conclusions : Four-hour post-ERCP serum amylase and lipase levels with cut-off values of 2.5x and 8x ULR are proven useful predictive values for earlier safe discharge of patients on the same day after ERCP.
- Fulltext
- Appears in Collections:
- Graduate School of Ajou University > Department of Medicine > 3. Theses(Master)
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