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Value of serum lipase in early diagnosis of pancreatitis after ERCP |
GONG Biyan1, ZENG Xia2, XIE Dan3, LIU Danqing4 |
1. General Surgery Department, 2. Out-Patient Department,Chongqing Municipal Corps Hospital of Chinese People's Armed Police Force,Chongqing 400061,China; 3. Department of Medical Insurance, the Fifth People's Hospital,Chongqing 400062,China; 4. Minimally Invasive Center for Hepatobiliary and Pancreatic Surgery, the First Hospital Affiliated to PLA Army Military Medical University, Chongqing 400038,China |
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Abstract 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 values of the ROC curve for early diagnosis of PEP, and the attributes of these values in the early diagnosis of pancreatitis after ERCP surgery(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.
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Received: 06 February 2024
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中华医学会消化病学分会胰腺疾病学组,中华胰腺病杂志编辑委员会,中华消化杂志编辑委员会.中国急性胰腺炎诊治指南(2019年,沈阳)[J].中华消化杂志,2019,39(11):721-730.
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