Published online Sep 16, 2019. doi: 10.4253/wjge.v11.i9.477
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
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.
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.
This study aimed to retrospectively examine the usefulness of s-Lip for the early diagnosis of PEP.
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.
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).
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.
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.