Document Type : Original research articles
Authors
1
Internal Medicine Department, Faculty of Medicine, South Valley University, Qena , Egypt.
2
Tropical Medicine Department, Faculty of Medicine, South Valley University, Qena, Egypt.
3
Clinical Pathology Department, Faculty of Medicine, South Valley University, Qena, Egypt.
10.21608/svuijm.2024.334129.2011
Abstract
Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post-ERCP pancreatitis (PEP) helps physicians to provide intensive care and possible medical treatment as early as possible. Trypsinogen 2 has recently gained attention as a useful biomarker for diagnosing and assessing the severity of acute PEP.
Objectives: to evaluate the role of the urinary trypsinogen-2 test in early diagnosis of PEP and compare its diagnostic value with serum amylase and lipase levels.
Patients and methods: We tested the urinary trypsinogen-2 test and serum levels of amylase and lipase in a total of 70 patients with obstructive jaundice after ERCP.
Results: PEP was diagnosed in 16 (22.9%) of 70 patients. At cutoff level ( >10.9 ng/ml ) , the sensitivity, specificity, PPV, NPV, and accuracy of urinary trypsinogen-2 test as a predictor of Post-ERCP pancreatitis at 3 hours after ERCP were 93.75%, 94.4 %, 83.3%, 98.1%, and 94.2%, respectively. At the cutoff level (>87 U/L) for amylase, the sensitivity, specificity, PPV , NPV, and accuracy were 75%, 83.3%, 57.1%, 91.8%, and 81.4 % respectively. At the cutoff level (>83 U/L) for lipase, the sensitivity, specificity, PPV, NPV, and accuracy were 75%, 66.7%, 40%, 90%, and 68.57 %, respectively.
Conclusions: Urinary TRY-2 is an accurate early marker for diagnosing post-ERCP pancreatitis, with high sensitivity, specificity, and accuracy outperforming serum amylase and lipase, and its strong link to clinical outcomes makes it a valuable noninvasive tool.
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