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ORIGINAL ARTICLE
Year : 2021  |  Volume : 11  |  Issue : 4  |  Page : 238-242

Role of 4-H serum lipase level in predicting postendoscopic retrograde cholangiopancreatography pancreatitis


1 Department of Gastrointestinal Hepatobiliary and Pancreatic Disorders, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Shahbag; Department of Medical Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Mohakhali, Bangladesh
2 Department of Orthopaedics, National Institute of Traumatology and Orthopedic Rehabilitation, Shere-Bangla Nagor, Dhaka, Bangladesh
3 Department of Gastrointestinal Hepatobiliary and Pancreatic Disorders, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Shahbag, Bangladesh
4 Department of Medical Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Mohakhali, Bangladesh
5 Department of Gastroenterology, Japan East West Medical College and Hospital, Dhaka, Bangladesh

Correspondence Address:
Sultana Parvin
Department of Medical Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Mohakhali, Dhaka 1212
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijabmr.ijabmr_192_21

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Introduction: Serum amylase level can rise asymptomatically after endoscopic retrograde cholangiopancreatography (ERCP). Thus, its assay can lead to overprediction of post-ERCP pancreatitis (PEP). Lipase assay is used to diagnose other forms of pancreatitis but usually not for PEP. Objectives: The aim of this study was to predict whether lipase may be of better use for the early prediction of PEP. Methods: One hundred and twenty-five consecutive ERCPs performed over a period of 1 year and 9 months were observed. On admission (baseline) and after ERCP at 4 and 24 h, serum amylase and lipase were measured. Based on sensitivity and specificity from the receiver operator characteristic (ROC) curve, optimal cutoff levels for the enzyme, serum lipase, and amylase levels were employed to predict PEP. Results: Out of 125 patients, 26 (20.8%) developed PEP. In multivariate analysis, young age, suspected sphincter of Oddi dysfunction, recurrent pancreatitis, and needle papillotomy were significant risk factors. Considering the optimum cutoff level (single value with the best sensitivity and specificity), both the enzyme amylase and lipase evaluated at 4 h were significant (Chi-square test: P =0.0001 for both the enzymes). However, multivariate regression analysis and levels of enzymes at different cutoff values in the ROC found that 4-h lipase levels were more (about 4 times) increased of the upper limit of normal range than amylase levels (1.19 times). Conclusion: The enzyme, serum amylase, and lipase evaluated at 4 h after ERCP were satisfactory predictors for PEP. However, when compared, serum lipase was more reliable than amylase.


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