Serum amylase, pancreatic stents, and pancreatitis after sphincter of Oddi manometry

Sean J. Sheehan, Jeffrey H. Lee, Carolyn K. Wells, Mark Topazian

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Serum amylase levels 2 hours after ERCP predict postprocedure pancreatitis. The value of serum amylase measurements after sphincter of Oddi manometry (SOM) and the effect of pancreatic-duct stent placement on serum amylase are unknown. Methods: Records were reviewed for 88 SOM patients who had serum amylase measured 2 hours after the procedure. Post-SOM pancreatitis was defined as pain with a >3-fold elevation of serum amylase on the morning after SOM. "Possible pancreatitis" was defined as pain with a <3-fold elevation of serum amylase on the morning after SOM. Results: Post-SOM pancreatitis and possible pancreatitis each occurred in 13% of the study cohort. Post-SOM pancreatitis was associated with the absence of a pancreatic stent and occurred in 0% of patients without a stent who had normal 2-hour serum amylase vs. 67% with elevated 2-hour serum amylase (p < 0.01). Among patients who received a stent, pancreatitis occurred in 6%, regardless of whether the 2-hour serum amylase was elevated. Possible pancreatitis occurred mainly in patients who received stents, and it also was associated with elevation of the 2-hour serum amylase. Conclusions: Elevation of the serum amylase level 2 hours after SOM predicts post-SOM pancreatitis but only in patients who do not receive a pancreatic stent. Among patients who received a stent, elevated 2-hour serum amylase levels predict subsequent findings that may be caused by attenuated pancreatitis.

Original languageEnglish (US)
Pages (from-to)260-265
Number of pages6
JournalGastrointestinal Endoscopy
Volume62
Issue number2
DOIs
StatePublished - Aug 1 2005

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Sphincter of Oddi
Manometry
Amylases
Pancreatitis
Stents
Serum
Pain
Endoscopic Retrograde Cholangiopancreatography
Pancreatic Ducts

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Serum amylase, pancreatic stents, and pancreatitis after sphincter of Oddi manometry. / Sheehan, Sean J.; Lee, Jeffrey H.; Wells, Carolyn K.; Topazian, Mark.

In: Gastrointestinal Endoscopy, Vol. 62, No. 2, 01.08.2005, p. 260-265.

Research output: Contribution to journalArticle

Sheehan, Sean J. ; Lee, Jeffrey H. ; Wells, Carolyn K. ; Topazian, Mark. / Serum amylase, pancreatic stents, and pancreatitis after sphincter of Oddi manometry. In: Gastrointestinal Endoscopy. 2005 ; Vol. 62, No. 2. pp. 260-265.
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N2 - Background: Serum amylase levels 2 hours after ERCP predict postprocedure pancreatitis. The value of serum amylase measurements after sphincter of Oddi manometry (SOM) and the effect of pancreatic-duct stent placement on serum amylase are unknown. Methods: Records were reviewed for 88 SOM patients who had serum amylase measured 2 hours after the procedure. Post-SOM pancreatitis was defined as pain with a >3-fold elevation of serum amylase on the morning after SOM. "Possible pancreatitis" was defined as pain with a <3-fold elevation of serum amylase on the morning after SOM. Results: Post-SOM pancreatitis and possible pancreatitis each occurred in 13% of the study cohort. Post-SOM pancreatitis was associated with the absence of a pancreatic stent and occurred in 0% of patients without a stent who had normal 2-hour serum amylase vs. 67% with elevated 2-hour serum amylase (p < 0.01). Among patients who received a stent, pancreatitis occurred in 6%, regardless of whether the 2-hour serum amylase was elevated. Possible pancreatitis occurred mainly in patients who received stents, and it also was associated with elevation of the 2-hour serum amylase. Conclusions: Elevation of the serum amylase level 2 hours after SOM predicts post-SOM pancreatitis but only in patients who do not receive a pancreatic stent. Among patients who received a stent, elevated 2-hour serum amylase levels predict subsequent findings that may be caused by attenuated pancreatitis.

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