The Predictivity of Serum Biochemical Markers in Acute Biliary Pancreatitis

Bülent Güngör,Cafer Polat,Kasım Çağlayan,Zafer Malazgirt,Deniz Şeren,Kenan Erzurumlu

doi:10.5402/2011/279607

Bülent Güngör, Cafer Polat + Show 4 more

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https://doi.org/10.5402/2011/279607

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Abstract

Background and Aim. There are no accurate methods of differentiating acute biliary pancreatitis. Obstructions of biliary ducts, idiopathic pancreatitis may be related with biliary origin which needs identification for acute treatment. We searched for the predictivity of biochemical markers in early acute biliary pancreatitis. Patients and Methods. Serum levels of AST (Aspartate Transaminase),ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), GGT (Gamma Glutamyl Transferase), total bilirubin, direct bilirubin, LDH (Lactate Dehydrogenase), amylase, lipase, CRP (C-Reactive Protein) and WBC (White Blood Cell) were measured in 157 patients with acute pancreatitis. Biliary and nonbiliary pancreatitis were differentiated by Magnetic Resonance Cholangiopancreatography (MRCP), Endoscopic Retrograde Cholangiopancreatography (ERCP), Intraoperative Cholangiopancreatography (IOC). Cut-off points of admission biochemical markers with sensitivity, specifity, positive predictive value and negative predictive value were determined after identification of significant variables. Receiver Operator Curves were plotted for each biochemical marker. Results. Serum Alkaline Phosphatase, total bilirubin, direct bilirubin, amylase and lipase levels were significantly higher in biliary pancreatitis with a positive predictive value of 80.8%, 83.9%, 81.6%, 78.8%, 79.7%. Conclusion. Increased Alkaline Phosphatase,total bilirubin, direct bilirubin, amylase and lipase levels may be used in prediction of biliary pancreatitis.

Highlights

Acute pancreatitis is a disease that could result in systemic inflammatory response, sepsis, multiorgan failure, and death
Morbidity and mortality of acute pancreatitis may be higher in biliary type
Distinguishing biliary pancreatitis from nonbiliary is important for the management like cholecystectomy, Endoscopic Retrograde Cholangiopancreatography (ERCP), and sphincterotomy

Summary

Introduction

Acute pancreatitis is a disease that could result in systemic inflammatory response, sepsis, multiorgan failure, and death. The stones in the distal common bile duct and the pancreatic duct could not be detected in all patients with biliary pancreatitis. We searched for the predictivity of biochemical markers in early acute biliary pancreatitis. Serum levels of AST (Aspartate Transaminase),ALT (Alanine Transaminase), ALP (Alkaline Phosphatase), GGT (Gamma Glutamyl Transferase), total bilirubin, direct bilirubin, LDH (Lactate Dehydrogenase), amylase, lipase, CRP (C-Reactive Protein) and WBC (White Blood Cell) were measured in 157 patients with acute pancreatitis. Serum Alkaline Phosphatase, total bilirubin, direct bilirubin, amylase and lipase levels were significantly higher in biliary pancreatitis with a positive predictive value of 80.8%, 83.9%, 81.6%, 78.8%, 79.7%. Increased Alkaline Phosphatase,total bilirubin, direct bilirubin, amylase and lipase levels may be used in prediction of biliary pancreatitis

Methods

Results

Conclusion