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Urinary trypsinogen-2 test strip in detecting ERCP-induced pancreatitis
E Kemppainen1, J Hedström, P Puolakkainen
1Second Dept. of Surgery, Helsinki University Central Hospital, Finland.
Endoscopy
|May 1, 1997
Summary
A new urinary trypsinogen-2 test strip accurately diagnoses pancreatitis after ERCP. This reliable, easy-to-use test shows comparable results to serum amylase for detecting pancreatic injury.
Area of Science:
- Gastroenterology
- Biochemistry
- Medical Diagnostics
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) can induce acute pancreatitis.
- Accurate and timely diagnosis of post-ERCP pancreatitis is crucial for patient management.
Purpose of the Study:
- To evaluate a novel immunochromatographic urinary trypsinogen-2 test strip for diagnosing acute pancreatitis following ERCP.
- To compare the diagnostic performance of the urinary trypsinogen-2 test strip with traditional serum and urine amylase measurements.
Main Methods:
- One hundred six patients undergoing ERCP were enrolled.
- Urinary trypsinogen-2 test strips were used six hours post-ERCP.
- Quantitative trypsinogen-2, serum amylase, and urine amylase were measured pre- and post-ERCP.
Main Results:
- Urinary trypsinogen-2 concentrations were significantly higher in patients with post-ERCP pancreatitis (median 1780 µg/l) compared to those without (median 3.6 µg/l).
- The test strip demonstrated high sensitivity (81%) and specificity (97%), comparable to serum amylase (91% sensitivity, 96% specificity).
- The test strip correlated well (kappa = 0.75) with quantitative trypsinogen-2 assays.
Conclusions:
- Increased urinary trypsinogen-2 concentration post-ERCP indicates pancreatic injury and is detectable by the test strip.
- The test strip is reliable, easy to perform, and suitable for outpatient use.
- Baseline urinary trypsinogen-2 levels should be assessed prior to ERCP; further clinical trials are needed to confirm its utility.