Value of serum lipase in early diagnosis of pancreatitis after ERCP
Objective To explore the value of serum lipase in the early diagnosis of pancreatitis after endoscopic retrograde cholangiopancreatography(ERCP).Methods A retrospective analysis was performed on 3190 patients who underwent ERCP in Chongqing Municipal Corps Hospital of Chinese People's Armed Police Force and PLA Army Military Medical University from March 2017 to March 2020 to compare the AUC area under the ROC curve of serum lipase(S-Lip)and amylase(S-Amy),the threshold val-ues of the ROC curve for early diagnosis of PEP,and the attributes of these values in the early diagnosis of pancreatitis after ERCP sur-gery(sensitivity,specificity,positive predictive value and negative predictive value).Results Among the 802 cases included in the study,56 cases(6.9%)of ERCP postoperative pancreatitis occurred,including 30 cases(53.6%)at 3 h after ERCP and 26 cases(46.4%)at 24 h after ERCP.The AUC of S-Lip and S-Amy were 0.93(95%confidence interval,0.87-0.96)and 0.865(95%CI,0.78-0.90)at 3 hours after ERCP,and the differences were statistically significant(P<0.01).ROC curve showed that the optimal threshold value were 382 U/L for s-Lip(sensitivity 0.88,specificity 0.89,PPV 0.502,NPV 0.985)and 228 U/L for s-Amy(sensitivity 0.82,specificity 0.78,PPV 0.363,NPV 0.977).Conclusions Serum lipase is characterized by high sensitivity and specificity in the early diagnosis of PEP,and its early detection value after ERCP provides an important basis for the early intervention of PEP.
ERCPpancreatitis after ERCPserum lipaseserum amylase
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