Tadehara M, Okuwaki K, Imaizumi H, Kida M, Iwai T, Yamauchi H, Kaneko T, Hasegawa R, Miyata E, Kawaguchi Y, Masutani H, Koizumi W. Usefulness of serum lipase for early diagnosis of post-endoscopic retrograde cholangiopancreatography pancreatitis. World J Gastrointest Endosc 2019; 11(9): 477-485 [PMID: 31558969 DOI: 10.4253/wjge.v11.i9.477]
Corresponding Author of This Article
Kosuke Okuwaki, MD, PhD, Doctor, Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 2520375, Japan. kokuwaki@kitasato-u.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Masayoshi Tadehara, Kosuke Okuwaki, Hiroshi Imaizumi, Mitsuhiro Kida, Tomohisa Iwai, Hiroshi Yamauchi, Toru Kaneko, Rikiya Hasegawa, Eiji Miyata, Yusuke Kawaguchi, Hironori Masutani, Wasaburo Koizumi, Department of Gastroenterology, Kitasato University School of Medicine, Sagamihara, Kanagawa 2520375, Japan
Author contributions: All authors helped to perform the research; Tadehara M wrote manuscript and performed procedures and data analysis; Okuwaki K and Imaizumi H drafted the concepts and designed the study; Kida M, Iwai T, Yamauchi H, Kaneko T, Hasegawa R, Miyata E, Kawaguchi Y, Masutani H and Koizumi W offered technical or material support; All the authors discussed the results and commented on the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Kitasato University.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to endoscopic retrograde cholangiopancreatography by written consent.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Kosuke Okuwaki, MD, PhD, Doctor, Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 2520375, Japan. kokuwaki@kitasato-u.ac.jp
Telephone: +81-42-7788111 Fax: +81-42-7789371
Received: July 12, 2019 Peer-review started: July 12, 2019 First decision: August 2, 2019 Revised: August 21, 2019 Accepted: August 9, 2019 Article in press: August 9, 2019 Published online: September 16, 2019 Processing time: 63 Days and 13.4 Hours
ARTICLE HIGHLIGHTS
Research background
Serum lipase (s-Lip) is considered the most useful pancreatic enzyme for diagnosing acute pancreatitis, and s-Lip is known to have greater diagnostic power than serum amylase (s-Amy). However, its usefulness for diagnosing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) has not been sufficiently investigated.
Research motivation
PEP is sometimes fatal. As such, PEP should be diagnosed early so that therapeutic interventions can be carried out. It is necessary to evaluate pancreatic enzymes that are useful for the early diagnosis of PEP.
Research objectives
This study aimed to retrospectively examine the usefulness of s-Lip for the early diagnosis of PEP.
Research methods
We retrospectively examined 4192 patients who underwent ERCP at our two hospitals over the last 5 years. The primary outcomes were a comparison of the areas under the receiver operating characteristic (ROC) curves (AUCs) of s-Lip and serum amylase (s-Amy), s-Lip and s-Amy cutoff values based on the presence or absence of PEP in the early stage after ERCP via ROC curves, and the diagnostic properties of these cutoff values for PEP diagnosis.
Research results
In total, 804 cases were registered. The AUCs were 0.908 for s-Lip [95% confidence interval (CI): 0.880-0.940, P < 0.001] and 0.880 for s-Amy (95%CI: 0.846-0.915, P < 0.001), indicating both are useful for early diagnosis. By comparing the AUCs, s-Lip was found to be significantly more useful for the early diagnosis of PEP than s-Amy (P = 0.023).
Research conclusions
S-Lip was significantly more useful for the early diagnosis of PEP. Measuring s-Lip after ERCP could help diagnose PEP early; hence, therapeutic interventions can be provided early.
Research perspectives
Measuring s-Lip is a useful option for the early diagnosis of PEP. However, this study was limited as a retrospective at two centers. The usefulness of s-Lip needs to be reexamined by prospectively registering cases as part of a multicenter study.
