Factors affecting pancreatic hyperamylasemia in patients undergoing peroral single-balloon enteroscopy

Dig Endosc. 2015 Sep;27(6):674-8. doi: 10.1111/den.12449. Epub 2015 Mar 4.

Abstract

Background and aim: Acute pancreatitis following balloon-assisted enteroscopy is a rare but serious complication. The causative mechanism is uncertain and prevention strategies are not established. We conducted a retrospective study to clarify the risk factors for pancreatic hyperamylasemia.

Methods: Eighty-four patients undergoing peroral single-balloon enteroscopy (SBE) were enrolled in this study. Serum pancreatic and salivary amylase levels were measured 2 h after endoscopic examination.

Results: We experienced three patients with post-SBE pancreatitis. Factors predicting pancreatic hyperamylasemia were: (i) elderly patients; (ii) deeper insertion; and (iii) clockwise insertion. In contrast, younger age at examination was a significant factor observed in salivary hyperamylasemia.

Conclusions: It is important to measure pancreatic amylase and not total amylase after SBE. When carrying out peroral SBE, the distance of insertion should be reduced especially if the scope traces a clockwise loop or the subject is elderly.

Keywords: acute pancreatitis; hyperamylasemia; oral insertion; risk factors; single-balloon enteroscopy.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Amylases / blood
  • Analysis of Variance
  • Cohort Studies
  • Endoscopes, Gastrointestinal*
  • Endoscopy, Gastrointestinal / adverse effects*
  • Endoscopy, Gastrointestinal / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperamylasemia / complications*
  • Hyperamylasemia / diagnosis
  • Male
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / adverse effects*
  • Natural Orifice Endoscopic Surgery / methods
  • Pancreatitis / etiology*
  • Pancreatitis / physiopathology
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Statistics, Nonparametric
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Young Adult

Substances

  • Amylases