title: Using the 4-hour Post-ERCP amylase level to predict post-ERCP pancreatitis.
abstract: BACKGROUND
  Post-ERCP pancreatitis is the most common complication of endoscopic retrograde cholangiopancreatography (ERCP). A simple method of predicting patients who are at risk of developing post-ERCP pancreatitis is needed to allow those at low risk to be discharged on the same day of their procedure. The aim of this study was to confirm that 4-hour post-ERCP serum amylase level is predictive of post-ERCP pancreatitis.
  
  
  METHODS
  A study of 886 ERCPs performed at a single centre was conducted.
  
  
  METHODS
  Four-hour amylase level was recorded, along with patient demographics, procedural details, presence of pancreatogram, and morbidity and mortality.
  
  
  RESULTS
  Pancreatitis occurred in 4.4% of ERCPs. Hyperamylasaemia was found to be predictive of post-ERCP pancreatitis, with other risk factors being a younger age and pancreatogram. Hyperamylasaemia was also predictive of post-ERCP pancreatitis in the subgroup of patients who had undergone pancreatogram.
  
  
  CONCLUSIONS
  The 4-hour amylase level is a useful measure in the prediction of post-ERCP pancreatitis. Patients who have undergone pancreatogram should be admitted if 4-hour amylase level is greater than 2.5 times the upper limit of reference. Patients who have not undergone pancreatogram should be admitted if 4-hour amylase level is greater than 5 times the upper limit of reference.
authors: Department of Surgery, Northeast Health, Wangaratta, Australia.
authors: Verity R
authors: VR
authors: Sutton
authors: Michael K Y
authors: MK
authors: Hong
authors: Peter R
authors: PR
authors: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000681:Amylases