2026-09-23T13:28:44Zhttps://repository.ajou.ac.kr/oai/request

oai:repository.ajou.ac.kr:201003/118722024-10-11T02:21:24Zcom_201003_14369com_201003_14368col_201003_14370

Prediction of Post-ERCP Pancreatitis by 4-Hour Post-ERCP Serum Amylase and Lipase Levels 4시간 후 혈청 아밀라아제와 리파아제 농도를 이용한 내시경 역행성 췌담도 조영술 이후 췌장염 발생의 예측 이, 연경 김, 진홍 대학원 의학과 108434 이, 연경 Acute Pancreatitis Endoscopic Retrograde Cholangiopancreatography Hyperamylasemia 급성췌장염 내시경 역행성 췌담도 조영술 고아밀라아제혈증 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. ABSTRACT INTRODUCTION MATERIALS AND METHODS RESULTS CONCLUSION REFERENCE 국문요약 Master 2015-11-02 2015-11-02 2015 2015 Thesis Theses http://repository.ajou.ac.kr/handle/201003/11872 http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000020149 000000020149 en