Abstract
Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible. Trypsinogen-2 in urine is a good diagnostic and prognostic marker of acute pancreatitis. Objectives: To evaluate the diagnostic value of urinary trypsinogen-2 dipstick test for early diagnosis of post ERCP pancreatitis. Methods: A total of 37 patients with obstructive jaundice were tested with the urinary trypsinogen-2 dipstick test and serum levels of amylase and lipase before ERCP and 6 hours after ERCP. Results: Post ERCP pancreatitis was diagnosed in 6 (16%) of 37 patients. The sensitivity, specificity, positive predictive value and negative predictive value of urinary trypsinogen-2 dipstick test at 6 hours after ERCP were 100%, 97%, 86%, 100% respectively. At the cutoff level (130 U/L) for lipase, the positive predictive value and negative predictive value all were (100%), however, the positive predictive value and negative predictive value for amylase levels at cutoff (122 U/L) were 60%, 100% respectively. Serum lipase level was the best test for diagnosing post ERCP pancreatitis followed by the urinary trypsinogen-2 dipstick test. Conclusions: The urinary trypsinogen-2 dipstick test can be used as a rapid and easy test for early diagnosis of post ERCP pancreatitis with high sensitivity and specificity.
Highlights
Since its first reported application in 1968, endoscopic retrograde cholangiopancreatography (ERCP) has become a valuable procedure for examination and treatment of pancreaticobiliary diseases [1]
Serum lipase level was the best test for diagnosing post ERCP pancreatitis followed by the urinary trypsinogen-2 dipstick test
A rapid test strip has been developed for the detection of trypsinogen-2 in urine (The urinary trypsinogen-2 dipstick test—UT2DSTactim pancreatitis) which is based on the immunochromatography principle and shows a good sensitivity and specificity in diagnosing acute pancreatitis [6]
Summary
Since its first reported application in 1968, endoscopic retrograde cholangiopancreatography (ERCP) has become a valuable procedure for examination and treatment of pancreaticobiliary diseases [1]. Measurement of serum amylase and lipase levels after the procedure may have a possible role for early recognition of post-ERCP pancreatitis [3]. Reports indicate that serum and urinary trypsinogen-2 concentrations increase in patients with acute pancreatitis and that trypsinogen-2 levels can serve as a more sensitive diagnostic marker for pancreatitis relative to amylase or lipase [1,5]. A rapid test strip has been developed for the detection of trypsinogen-2 in urine (The urinary trypsinogen-2 dipstick test—UT2DSTactim pancreatitis) which is based on the immunochromatography principle and shows a good sensitivity and specificity in diagnosing acute pancreatitis [6]. The aim of this study was to evaluate the diagnostic value of urinary trypsinogen-2 dipstick test for early diagnosis of post-ERCP pancreatitis
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