title: Risk Factors of Acute Pancreatitis in Oral Double Balloon Enteroscopy.
abstract: Double balloon enteroscopy (DBE) was introduced 15 years ago. The complications of diagnostic DBE are rare, acute pancreatitis is most redoubtable one (incidence about 0.3%). Hyperamylasemia after DBE seems to be a rather common condition respectively. The most probable cause seems to be a mechanical straining of the pancreas. We tried to identify patients in a higher risk of acute pancreatitis after DBE. We investigated several laboratory markers before and after DBE (serum cathepsin B, lactoferrin, E-selectin, SPINK 1, procalcitonin, S100 proteins, alfa-1-antitrypsin, hs-CRP, malondialdehyde, serum and urine amylase and serum lipase). Serum amylase and lipase rose significantly with the maximum 4 hours after DBE. Serum cathepsin and procalcitonin decreased significantly 4 hours after DBE compared to healthy controls and patients values before DBE. Either serum amylase or lipase 4 hours after DBE did not correlate with any markers before DBE. There was a trend for an association between the number of push-and-pull cycles and procalcitonin and urine amylase 4 hours after DBE; between procalcitonin and alfa-1-antitrypsin, cathepsin and hs-CRP; and between E-selectin and malondialdehyde 4 hours after DBE. We found no laboratory markers determinative in advance those patients in a higher risk of acute pancreatitis after DBE.
authors.affiliation: 2nd Department of Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic. marcela.kopacova@fnhk.cz.
authors.forename: Marcela
authors.initials: M
authors.lastname: Kopáčová
authors.affiliation: 2nd Department of Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Bureš
authors.affiliation: 2nd Department of Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic.
authors.forename: Stanislav
authors.initials: S
authors.lastname: Rejchrt
authors.affiliation: Institute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic.
authors.forename: Jaroslava
authors.initials: J
authors.lastname: Vávrová
authors.affiliation: 2nd Department of Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic.
authors.forename: Jolana
authors.initials: J
authors.lastname: Bártová
authors.affiliation: 2nd Department of Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Soukup
authors.affiliation: 2nd Department of Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Tomš
authors.affiliation: 2nd Department of Medicine - Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic.
authors.forename: Ilja
authors.initials: I
authors.lastname: Tachecí
mesh_terms: D000208:Acute Disease; D000681:Amylases / Q000097:blood / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002097:C-Reactive Protein / Q000378:metabolism; D002116:Calcitonin / Q000097:blood; D016022:Case-Control Studies; D002403:Cathepsins / Q000097:blood; D058582:Double-Balloon Enteroscopy / Q000009:adverse effects*; D019040:E-Selectin / Q000097:blood; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000097:blood / Q000209:etiology; D008049:Lipase / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000097:blood; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood* / Q000209:etiology*; D012307:Risk Factors; D000515:alpha 1-Antitrypsin / Q000097:blood
chemical_list: D015415:Biomarkers; D019040:E-Selectin; C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin; D008315:Malondialdehyde; D002116:Calcitonin; D002097:C-Reactive Protein; D008049:Lipase; D000681:Amylases; D002403:Cathepsins
keywords: Acute pancreatitis; Deep enteroscopy; Device assisted endoscopy; Double balloon enteroscopy; Hyperamylasemia; Small intestinal disorders