Alanine aminotransferase in biliary acute pancreatitis
Alanino aminotrasferasa en pancreatitis aguda de origen biliar
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Aldana Dimas, G. E., Lleras Riaño, J. D., Acero Fagua, F., & Pabón Parra, M. G. (2013). Alanine aminotransferase in biliary acute pancreatitis. Journal of Medicine and Surgery Repertoire, 22(2), 108–113. https://doi.org/10.31260/RepertMedCir.v22.n2.2013.858
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Abstract
Acute pancreatitis (AP) exhibits high prevalence and high social and economic impact. It is mainly of biliary etiology in our setting. Endoscopic ultrasonography is not always available due to its high costs. Alanine aminotransferase (ALT) Ievels greater than 150 UI/1 have been related to biliary duct obstruction. Objective: to determine ALT features among our population to establish biliary etiology. Materials and Methods: a cross sectional study at Hospital de San José, Bogotá DC. The medica) records of all patients with AP from August 2010 to March 2012 were reviewed. Social, demographic, clinical, laboratory, imaging, intraoperative findings and etiologic diagnosis data were analyzed. Results: 106 patients were recruited, 67% females. An ROC analysis established that at ALT Ievels greater than 74 IU/1 there was greater sensibility and specificity than at ALT Ievels of 150 IU/1. The relation between greater than 74 UI/1 ALT levels with hyperbilirrubinemia, jaundice and ultrasonographic findings compatible with biliary etiology was found. Conclusion: there is statistically significant correlations between ALT Ievels greater than 74UI/I and biliary etiology (sensibility 89 %, specificity 71 %), p <0.001. Further studies comparing this diagnostic test with endoscopic ultrasonography are required.
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4. Cappell MS. Acute pancreatitis: etiology, clinical presentation. diagnosis, and therapy. Med Clin N Am. 2008 Jul;(4):889-x.
5. Saraswat VA, Sharma BC, Agarwal DK, Kumar R, Negi TS, Tandon RK. Biliary microlithiasis in patients with idiopathic acule pancreatitis and un explained biliary pain: response to therapy. J Gastroenterol Hepatol. 2004 Oct;19(10):1206-11.
6. Kaw M. Brodmerkel GJ, Jr. ERCP, biliary crystal analysis, and sphincter of Oddi manometry in idiopathic recurrent paocreatitis. Gastrointest Endose. 2002 Feb;55(2):157-62.
Anderson K, Brown LA, Daniel P, Connor SJ. Alanine transaminase rather than abdominal ultrasound alone is an importaot investigation to justify chole cystectomy in patients presenting with acule pancreatitis. HPB (Oxford). 2010 Jun;12(5):342-7.
8. Alexakis N, Lombard M, Raraty M, Ghaneh P, Smart HL, Gilmore 1, et al. When is pancreatitis considered to be of biliary origin and what are the implications far management?. Pancreatology. 2007: 7(2-3):131-41.
9. Kiriyama S. Gabata T, Takada T, Hirata K, Yoshida M, Mayumi T, et al. New diagnostic criteria of acure pancreatitis. J Hepatobiliary Pancreat Sci. 2010 Jan;(1):24-36.
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1 l. Chak A. Hawes RH, Cooper OS, Hoffman B, Catalana MF. Wong RC, et al. Prospective assessment of the utility of EUS in the evaluation of gallstone pan creatitis. Gastrointest Endosc.1999 May;(5):599-604.
12. Ainsworth AP, Rafaelsen SR, Wamberg PA, Pless T, Durup J, Mortensen MB. Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholan giopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease. Scand J Gastroenterol. 2004 Jun;(6):579-83.
13. Smotkin J, Tenner S. Laboratory diagnostic tests in acute pancreatitis. J Clin Gastroenterol. 2002 Apr;(4):459-62.
14. Liu CL, Fan ST, Lo CM, Tso WK, Wong Y, Poon RT, et al. Clinico-biochemical prediction of biliary cause of acule pancreatitis in the era of endoscopic ultraso nography. Aliment Pharmacol Ther. 2005 Sep 1;(5):423-31.
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16. Dholakia K, Pitchumoni CS, Agarwal N. How often are liver function tests nor mal in acute biliary pancreatitis?. J Clin Gastroenterol. 2004 Jan;(1):81-3.
17. Raraty MG, Finch M, Neoptolemos JP. Acute cholangitis and pancreatitis se condary to common duct stones: management update. World J Surg. 1998 Nov;(l l):1155-61.
18. Wang SS, Lin XZ, Tsai YT, Lee SD, Pan HB, Chou YH, et al. Clinical signifi cance of ultrasonography, computed tomography, and biochemical tests in the rapid diagnosis of gallstone-related pancreatitis: a prospective study. Pancreas. 1988;(2):153-8.
19. Chwistek M, Roberts 1, Amoateng-Adjepong Y. Gallstone pancreatitis: a com munity 1eaching hospital experience. J Clin Gastroenterol. 2001 Jul;( l):41-4.
20. Alexakis N, Neoptolemos JP. Algorithm for the diagnosis and Lreatment of acule biliary pancreatitis. Scand J Surg. 2005;94(2):124-9..
21. Matull WR, Pereira SP, O'Donohue JW. Biochemical markers of acute pancrea titis. J Clin Pathol. 2006 Apr;(4):340-4.
22. Kemppainen E, Puolakkainen P. Non-alcoholic etiologies of acute pancreatitis exclusion of other etiologic factors besides alcohol and gallstoncs. Pancreatolo gy. 2007:(2-3):142-6.
23. Stimac D, Rubinic M, Lenac T, Kovac D, Vcev A, Miletic D. Biochemical pa rameters in the early differentiation of the etiology of acute pancreatitis. Am J Gastroenterol. 1996 Nov;9 1(11):2355-9.
24. Folsch UR, Nitsche R, Ludtke R, Hilgers RA, Creutzfeldt W. Early ERCP and papillotomy compared with conservative treatment for acule biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med. 1997 Jan 23;(4):237-42.
25. Sanjay P, Yeeting S, Whigham C. Judson HK, Kulli C, Polignano FM, et al. Managemenl guidelines for gallstone pancreatitis.Are the targets achievable?. J Pancreas. 2009;(1):43-7.
26. Kimura Y, Takada T, Kawarada Y. Hirata K, Mayumi T, Yoshida M, et al. JPN Guidelines for the management of acute pancreatitis: treatment of gallstone-in duced acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006;(1):56-60.
27. Graham DF, Wyllie FJ. Prediction of gall-stone pancreatitis by computer. Br Med J. 1979 Feb 24;1(6162):515-7.
28. Campbell EJ, Montgomery DA, Mackay CJ. A national survey of current surgical treatment of acute gallstone disease. Surg Laparosc Endose Percutan Tech. 2008 Jun;(3):242-7.
29. Kaw M. AI-Antably Y,Kaw P. Management of gallstone pancreatitis: cholecys tectomy or ERCP and endoscopic sphincterotomy.Gastrointest Endose. 2002 Jul;56(1):61-5.
2. Nieto J. Rodriguez S. Manejo de la pancreatitis aguda: guía de práctica clínica basada en la mejor infom1ación disponible. Rev Colomb Cir. 2010;25:76-96
3. Stabuc B, Drobne D, Ferkolj 1, Gruden A, Jereb J, Kolar G, et al. Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound. Eur J Gastroenterol Hepatol. 2008 Dec;20(12):1171-5.
4. Cappell MS. Acute pancreatitis: etiology, clinical presentation. diagnosis, and therapy. Med Clin N Am. 2008 Jul;(4):889-x.
5. Saraswat VA, Sharma BC, Agarwal DK, Kumar R, Negi TS, Tandon RK. Biliary microlithiasis in patients with idiopathic acule pancreatitis and un explained biliary pain: response to therapy. J Gastroenterol Hepatol. 2004 Oct;19(10):1206-11.
6. Kaw M. Brodmerkel GJ, Jr. ERCP, biliary crystal analysis, and sphincter of Oddi manometry in idiopathic recurrent paocreatitis. Gastrointest Endose. 2002 Feb;55(2):157-62.
Anderson K, Brown LA, Daniel P, Connor SJ. Alanine transaminase rather than abdominal ultrasound alone is an importaot investigation to justify chole cystectomy in patients presenting with acule pancreatitis. HPB (Oxford). 2010 Jun;12(5):342-7.
8. Alexakis N, Lombard M, Raraty M, Ghaneh P, Smart HL, Gilmore 1, et al. When is pancreatitis considered to be of biliary origin and what are the implications far management?. Pancreatology. 2007: 7(2-3):131-41.
9. Kiriyama S. Gabata T, Takada T, Hirata K, Yoshida M, Mayumi T, et al. New diagnostic criteria of acure pancreatitis. J Hepatobiliary Pancreat Sci. 2010 Jan;(1):24-36.
10. Kalloo AN, Kantsevoy SV. Gallstones and biliary disease. Prim Care. 2001 Sep;28(3):591-606
1 l. Chak A. Hawes RH, Cooper OS, Hoffman B, Catalana MF. Wong RC, et al. Prospective assessment of the utility of EUS in the evaluation of gallstone pan creatitis. Gastrointest Endosc.1999 May;(5):599-604.
12. Ainsworth AP, Rafaelsen SR, Wamberg PA, Pless T, Durup J, Mortensen MB. Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholan giopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease. Scand J Gastroenterol. 2004 Jun;(6):579-83.
13. Smotkin J, Tenner S. Laboratory diagnostic tests in acute pancreatitis. J Clin Gastroenterol. 2002 Apr;(4):459-62.
14. Liu CL, Fan ST, Lo CM, Tso WK, Wong Y, Poon RT, et al. Clinico-biochemical prediction of biliary cause of acule pancreatitis in the era of endoscopic ultraso nography. Aliment Pharmacol Ther. 2005 Sep 1;(5):423-31.
15. Levy P, Boruchowicz A, Hastier P. Pariente A, Thevenot T. Frossard JL. et al. Diagnosticcriteria in predicting a biliary origin of acule pancreatitis in the era of endoscopic ultrasound: multicentre prospective evaluation of 213 patients. Pan creatology. 2005;(4-5):450-6.
16. Dholakia K, Pitchumoni CS, Agarwal N. How often are liver function tests nor mal in acute biliary pancreatitis?. J Clin Gastroenterol. 2004 Jan;(1):81-3.
17. Raraty MG, Finch M, Neoptolemos JP. Acute cholangitis and pancreatitis se condary to common duct stones: management update. World J Surg. 1998 Nov;(l l):1155-61.
18. Wang SS, Lin XZ, Tsai YT, Lee SD, Pan HB, Chou YH, et al. Clinical signifi cance of ultrasonography, computed tomography, and biochemical tests in the rapid diagnosis of gallstone-related pancreatitis: a prospective study. Pancreas. 1988;(2):153-8.
19. Chwistek M, Roberts 1, Amoateng-Adjepong Y. Gallstone pancreatitis: a com munity 1eaching hospital experience. J Clin Gastroenterol. 2001 Jul;( l):41-4.
20. Alexakis N, Neoptolemos JP. Algorithm for the diagnosis and Lreatment of acule biliary pancreatitis. Scand J Surg. 2005;94(2):124-9..
21. Matull WR, Pereira SP, O'Donohue JW. Biochemical markers of acute pancrea titis. J Clin Pathol. 2006 Apr;(4):340-4.
22. Kemppainen E, Puolakkainen P. Non-alcoholic etiologies of acute pancreatitis exclusion of other etiologic factors besides alcohol and gallstoncs. Pancreatolo gy. 2007:(2-3):142-6.
23. Stimac D, Rubinic M, Lenac T, Kovac D, Vcev A, Miletic D. Biochemical pa rameters in the early differentiation of the etiology of acute pancreatitis. Am J Gastroenterol. 1996 Nov;9 1(11):2355-9.
24. Folsch UR, Nitsche R, Ludtke R, Hilgers RA, Creutzfeldt W. Early ERCP and papillotomy compared with conservative treatment for acule biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med. 1997 Jan 23;(4):237-42.
25. Sanjay P, Yeeting S, Whigham C. Judson HK, Kulli C, Polignano FM, et al. Managemenl guidelines for gallstone pancreatitis.Are the targets achievable?. J Pancreas. 2009;(1):43-7.
26. Kimura Y, Takada T, Kawarada Y. Hirata K, Mayumi T, Yoshida M, et al. JPN Guidelines for the management of acute pancreatitis: treatment of gallstone-in duced acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006;(1):56-60.
27. Graham DF, Wyllie FJ. Prediction of gall-stone pancreatitis by computer. Br Med J. 1979 Feb 24;1(6162):515-7.
28. Campbell EJ, Montgomery DA, Mackay CJ. A national survey of current surgical treatment of acute gallstone disease. Surg Laparosc Endose Percutan Tech. 2008 Jun;(3):242-7.
29. Kaw M. AI-Antably Y,Kaw P. Management of gallstone pancreatitis: cholecys tectomy or ERCP and endoscopic sphincterotomy.Gastrointest Endose. 2002 Jul;56(1):61-5.