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

• Published in: Digestive Endoscopy Vol. 27; no. 6; pp. 674 - 678
• Main Authors: Tsujikawa, Tomoyuki, Bamba, Shigeki, Inatomi, Osamu, Hasegawa, Hiroshi, Ban, Hiromitsu, Nishida, Atsushi, Imaeda, Hirotsugu, Itoh, Akihiko, Saotome, Takao, Sasaki, Masaya, Andoh, Akira
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.09.2015; Wiley
• Subjects: acute pancreatitis; Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Amylases; Amylases - blood; Analysis of Variance; Cohort Studies; Endoscopes, Gastrointestinal; Endoscopy, Gastrointestinal; Endoscopy, Gastrointestinal - adverse effects; Endoscopy, Gastrointestinal - methods; Female; Follow-Up Studies; Humans; Hyperamylasemia; Hyperamylasemia - complications; Hyperamylasemia - diagnosis; Male; Middle Aged; Natural Orifice Endoscopic Surgery; Natural Orifice Endoscopic Surgery - adverse effects; Natural Orifice Endoscopic Surgery - methods; oral insertion; Pancreatitis; Pancreatitis - etiology; Pancreatitis - physiopathology; Retrospective Studies; Risk Assessment; Risk Factors; Sex Factors; single-balloon enteroscopy; Statistics, Nonparametric; Tomography, X-Ray Computed; Tomography, X-Ray Computed - methods; Treatment Outcome; Young Adult; risk factors; hyperamylasemia; single-balloon enteroscopy; acute pancreatitis; oral insertion
• ISSN: 0915-5635; 1443-1661; 1443-1661
• DOI: 10.1111/den.12449

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.