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

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...

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Published inDigestive 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
LanguageEnglish
Published Australia Blackwell Publishing Ltd 01.09.2015
Wiley
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Online AccessGet full text
ISSN0915-5635
1443-1661
1443-1661
DOI10.1111/den.12449

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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.
AbstractList 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.BACKGROUND AND AIMAcute 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.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.METHODSEighty-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.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.RESULTSWe 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.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.CONCLUSIONSIt 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.
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. 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. 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. 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.
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.
Author Inatomi, Osamu
Imaeda, Hirotsugu
Andoh, Akira
Tsujikawa, Tomoyuki
Hasegawa, Hiroshi
Itoh, Akihiko
Saotome, Takao
Ban, Hiromitsu
Bamba, Shigeki
Nishida, Atsushi
Sasaki, Masaya
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Keywords risk factors
hyperamylasemia
single-balloon enteroscopy
acute pancreatitis
oral insertion
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References Eisen GM, Schreiner M. Small-bowel endoscopy. Endoscopy 2007; 39: 113-117.
Honda K, Mizutani T, Nakamura K et al. Acute pancreatitis associated with peroral double-balloon enteroscopy: A case report. World J. Gastroenterol. 2006; 12: 1802-1804.
Aktas H, de Ridder L, Haringsma J, Kuipers EJ, Mensink PB. Complications of single-balloon enteroscopy: A prospective evaluation of 166 procedures. Endoscopy 2010; 42: 365-368.
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Kawamura T, Yasuda K, Tanaka K et al. Clinical evaluation of a newly developed single-balloon enteroscope. Gastrointest. Endosc. 2008; 68: 1112-1116.
Mensink PB, Aktas H, Zelinkova Z, West RL, Kuipers EJ, van der Woude CJ. Impact of double-balloon enteroscopy findings on the management of Crohn's disease. Scand. J. Gastroenterol. 2010; 45: 483-489.
Tsujikawa T, Saitoh Y, Andoh A et al. Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine: Preliminary experiences. Endoscopy 2008; 40: 11-15.
Jarbandhan SV, van Weyenberg SJ, van der Veer WM, Heine DG, Mulder CJ, Jacobs MA. Double balloon endoscopy associated pancreatitis: A description of six cases. World J. Gastroenterol. 2008; 14: 720-724.
Sunada K, Yamamoto H. Double-balloon endoscopy: Past, present, and future. J. Gastroenterol. 2009; 44: 1-12.
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Cotton PB, Lehman G, Vennes J et al. Endoscopic sphincterotomy complications and their management: An attempt at consensus. Gastrointest. Endosc. 1991; 37: 383-393.
Matsushita M, Shimatani M, Uchida K, Okazaki K. Mechanism of acute pancreatitis after peroral double-balloon enteroscopy. Endoscopy 2007; 39: 480, author reply 1.
Yamamoto H, Sekine Y, Sato Y et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest. Endosc. 2001; 53: 216-220.
Ohtsuka Y, Shimizu T, Shoji H et al. Neonatal transient eosinophilic colitis causes lower gastrointestinal bleeding in early infancy. J. Pediatr. Gastroenterol. Nutr. 2007; 44: 501-505.
Groenen MJ, Moreels TG, Orlent H, Haringsma J, Kuipers EJ. Acute pancreatitis after double-balloon enteroscopy: An old pathogenetic theory revisited as a result of using a new endoscopic tool. Endoscopy 2006; 38: 82-85.
Honda K, Itaba S, Mizutani T et al. An increase in the serum amylase level in patients after peroral double-balloon enteroscopy: An association with the development of pancreatitis. Endoscopy 2006; 38: 1040-1043.
Kopacova M, Tacheci I, Rejchrt S, Bartova J, Bures J. Double balloon enteroscopy and acute pancreatitis. World J. Gastroenterol. 2010; 16: 2331-2340.
Mensink PB, Haringsma J, Kucharzik T et al. Complications of double balloon enteroscopy: A multicenter survey. Endoscopy 2007; 39: 613-615.
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References_xml – reference: Nakamura M, Kobashikawa K, Tamura J et al. [A case of 5-fluorouracil-induced hyperammmonia after chemotherapy for metastatic colon cancer]. Nippon Shokakibyo Gakkai Zasshi 2009; 106: 1744-1750.
– reference: Cotton PB, Lehman G, Vennes J et al. Endoscopic sphincterotomy complications and their management: An attempt at consensus. Gastrointest. Endosc. 1991; 37: 383-393.
– reference: Tsujikawa T, Saitoh Y, Andoh A et al. Novel single-balloon enteroscopy for diagnosis and treatment of the small intestine: Preliminary experiences. Endoscopy 2008; 40: 11-15.
– reference: Moschler O, May AD, Muller MK, Ell C. [Complications in double-balloon-enteroscopy: Results of the German DBE register]. Z. Gastroenterol. 2008; 46: 266-270.
– reference: Honda K, Mizutani T, Nakamura K et al. Acute pancreatitis associated with peroral double-balloon enteroscopy: A case report. World J. Gastroenterol. 2006; 12: 1802-1804.
– reference: Groenen MJ, Moreels TG, Orlent H, Haringsma J, Kuipers EJ. Acute pancreatitis after double-balloon enteroscopy: An old pathogenetic theory revisited as a result of using a new endoscopic tool. Endoscopy 2006; 38: 82-85.
– reference: Matsushita M, Shimatani M, Uchida K, Okazaki K. Mechanism of acute pancreatitis after peroral double-balloon enteroscopy. Endoscopy 2007; 39: 480, author reply 1.
– reference: Mensink PB, Haringsma J, Kucharzik T et al. Complications of double balloon enteroscopy: A multicenter survey. Endoscopy 2007; 39: 613-615.
– reference: Sunada K, Yamamoto H. Double-balloon endoscopy: Past, present, and future. J. Gastroenterol. 2009; 44: 1-12.
– reference: Jarbandhan SV, van Weyenberg SJ, van der Veer WM, Heine DG, Mulder CJ, Jacobs MA. Double balloon endoscopy associated pancreatitis: A description of six cases. World J. Gastroenterol. 2008; 14: 720-724.
– reference: Mensink PB, Aktas H, Zelinkova Z, West RL, Kuipers EJ, van der Woude CJ. Impact of double-balloon enteroscopy findings on the management of Crohn's disease. Scand. J. Gastroenterol. 2010; 45: 483-489.
– reference: Aktas H, de Ridder L, Haringsma J, Kuipers EJ, Mensink PB. Complications of single-balloon enteroscopy: A prospective evaluation of 166 procedures. Endoscopy 2010; 42: 365-368.
– reference: Ohtsuka Y, Shimizu T, Shoji H et al. Neonatal transient eosinophilic colitis causes lower gastrointestinal bleeding in early infancy. J. Pediatr. Gastroenterol. Nutr. 2007; 44: 501-505.
– reference: May A, Ell C. Push-and-pull enteroscopy using the double-balloon technique/double-balloon enteroscopy. Dig. Liver Dis. 2006; 38: 932-938.
– reference: Kopacova M, Tacheci I, Rejchrt S, Bartova J, Bures J. Double balloon enteroscopy and acute pancreatitis. World J. Gastroenterol. 2010; 16: 2331-2340.
– reference: Yamamoto H, Sekine Y, Sato Y et al. Total enteroscopy with a nonsurgical steerable double-balloon method. Gastrointest. Endosc. 2001; 53: 216-220.
– reference: Kawamura T, Yasuda K, Tanaka K et al. Clinical evaluation of a newly developed single-balloon enteroscope. Gastrointest. Endosc. 2008; 68: 1112-1116.
– reference: Eisen GM, Schreiner M. Small-bowel endoscopy. Endoscopy 2007; 39: 113-117.
– reference: Honda K, Itaba S, Mizutani T et al. An increase in the serum amylase level in patients after peroral double-balloon enteroscopy: An association with the development of pancreatitis. Endoscopy 2006; 38: 1040-1043.
– reference: Heine GD, Hadithi M, Groenen MJ, Kuipers EJ, Jacobs MA, Mulder CJ. Double-balloon enteroscopy: Indications, diagnostic yield, and complications in a series of 275 patients with suspected small-bowel disease. Endoscopy 2006; 38: 42-48.
– volume: 38
  start-page: 42
  year: 2006
  end-page: 48
  article-title: Double‐balloon enteroscopy: Indications, diagnostic yield, and complications in a series of 275 patients with suspected small‐bowel disease
  publication-title: Endoscopy
– volume: 106
  start-page: 1744
  year: 2009
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Snippet Background and Aim Acute pancreatitis following balloon‐assisted enteroscopy is a rare but serious complication. The causative mechanism is uncertain and...
Acute pancreatitis following balloon-assisted enteroscopy is a rare but serious complication. The causative mechanism is uncertain and prevention strategies...
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SubjectTerms 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
Title Factors affecting pancreatic hyperamylasemia in patients undergoing peroral single-balloon enteroscopy
URI https://api.istex.fr/ark:/67375/WNG-V304G5MW-7/fulltext.pdf
https://cir.nii.ac.jp/crid/1870020692775847552
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fden.12449
https://www.ncbi.nlm.nih.gov/pubmed/25630832
https://www.proquest.com/docview/1711546231
Volume 27
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