Recognition of ERC-induced pancreatitis in patients with choledocholithiasis by an analysis of laboratory findings.
OBJECTIVE
This study retrospectively analyses the relative value of various laboratory tests in the diagnosis of procedure-related pancreatitis in patients submitted to endoscopic retrograde cholangiography with sphincterotomy due to choledocholithiasis.


METHODS
A detailed laboratory assessment was performed on 238 patients 4, 10, 24, 48 and 72 hours after undergoing endoscopic sphincterotomy.


RESULTS
Of the 238 patients analyzed, 16 (6.7%) had a complication, including pancreatitis in 6 (2.5%), hemorrhage in 4 (1.7%), acute cholangitis in 3 (1.3%), and perforation in 3 (1.3%). In patients developing acute pancreatitis a significant rise was noted not only in serum amylase but also in the white blood cell count and aspargine transaminase at 24 hours following endoscopic sphincterotomy. Endoscopic procedure (difficulty in cannulating the bile duct and/or obtaining cholangiogram) was a significant risk factor for complications.


CONCLUSIONS
It is possible to stratify patients according to their risk of developing pancreatitis according to serum amylase, white blood cells and aspargine transaminase levels monitored for at least 24 hours following ERC. Patients for whom the procedure was difficult and selective cholangiogram was not obtained are at increased risk of developing procedure-related complications.
Wojtun
S
S
Digestive Endoscopy Unit, Central Clinical Hospital, Armed Forces Medical Academy, Warsaw, Poland.
Gil
M
M
Gil
J
J
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D000681:Amylases / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D005260:Female; D042882:Gallstones / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007958:Leukocyte Count; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis*; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000681:Amylases