Table 2

Definition and severity of post-ERCP pancreatitis
Study Definition of post-ERCP pancreatitis Severity of post-ERCP pancreatitis
Wollschläger et al. [21] Presence of abdominal pain attributed to pancreatitis, in association with a serum lipase or amylase level greater than 2 times the upper limit of normal NA
Budzyńska et al. [22] Presence of abdominal pain attributed to pancreatitis, together with a need for an unplanned hospitalization or an extension of a planned hospitalization by at least 2 d, and a serum amylase at least 3 times above the upper limit of normal at 24 hours after ERCP Mild: symptoms lasting up to 3 d and pancreas normal on the CT scan; moderate: requiring specific therapeutic measures for 4–10 d, Balthazar’s grade B/C on CT; severe: local or systemic complications for more than 10 d, Balthazar’s grade D/E on CT, or death
Lavy et al. [23] Presence of abdominal pain attributed to pancreatitis, in association with elevated amylase levels at least 3 times higher than the upper limit of normal Mild: requiring 2–3 d of hospitalization; moderate: requiring 4–10 d of hospitalization; severe: requiring 10 d of hospitalization or requiring surgical intervention or leading to death
Katsinelos et al. [24] Presence of abdominal pain attributed to pancreatitis, together with a need for an unplanned hospitalization or an extension of a planned hospitalization by at least 2 d, and a serum amylase at least 3 times above the upper limit of normal at 24 hours after ERCP Mild: symptoms persisting for 3 d and a normal appearance of the pancreas by US and/or CT; moderate: requirement for specific therapeutic measures for 4 to 10 d (Balthazar’s grade B/C on CT); severe: local or systemic complications for more than 10 d after ERCP (Balthazar’s grade D/E) or death
Katsinelos et al. [25] Presence of abdominal pain attributed to pancreatitis, together with a need for an unplanned hospitalization or an extension of a planned hospitalization by at least 2 d, and a serum amylase at least 3 times above the upper limit of normal at 24 hours after ERCP Mild: symptoms persisting for 3 d and a normal appearance of the pancreas by US and/or CT; moderate: requirement for specific therapeutic measures for 4 to 10 d (Balthazar’s grade B/C on CT); severe: local or systemic complications for more than 10 d after ERCP (Balthazar’s grade D/E) or death
Mosler et al. [26] New-onset or increased abdominal pain lasted for more than 24 h, caused an unplanned admission of an outpatient for more than one night, or prolonged a planned admission of an inpatient, and was associated with a serum amylase level increase of at least 3 times above normal, at approximately 18 hours (the next morning) after ERCP Mild: hospitalization lasted 2–3 d; moderate: hospitalization lasted 4–10 d; severe: hospitalization was prolonged for more than 1 0 d or any of the following occurred: hemorrhagic pancreatitis, pancreatic necrosis, pancreatic pseudocyst, or the need for percutaneous drainage or surgery
Milewski et al. [27] Clinical features consistent with acute pancreatitis beginning after ERCP and lasting for at least 24 h, associated with increase in serum amylase levels greater than 5 times above normal NA
Kapetanos et al. [28] Presence of abdominal pain attributed to pancreatitis, together with a need for an unplanned hospitalization or an extension of a planned hospitalization by at least 2 d, and a serum amylase at least 3 times above the upper limit of normal at 24 hours after ERCP Mild: clinical pancreatitis and serum amylase at least 3 times higher than normal at more than 24 h after ERCP, requiring admission or prolongation of planned admission for 2–3 d; moderate: required hospitalization for 4–10 d; severe: required hospitalization for more than 10 d, an intervention (percutaneous drainage or surgery), or if a pseudocyst was diagnosed
Romagnuolo et al. [29] Presence of typical pancreatic pain (epigastric pain often radiating into the back and associated with nausea and/or vomiting) requiring medical attention, in association with a serum lipase or amylase level greater than 2 times the upper limit of normal NA
Martinez et al. [30] Serum amylase was above 600 UI/L or 3 times above the normal value and the patient had a sharp pain irradiating to the back and nausea or vomiting Ranson’s criteria (Parameter: At admission: age >55 y, WBC count >16,000/uL, serum glucose level >11.1 mmol/L, SLDH/ALT >350 IU/L, AST level >250 IU/L; During initial 48 h: hematocrit: decrease of more than 0.10, BUN level: increase of more than 5 mg/dL, calcium: <2 mmol/L, PaO2<60 mm Hg, base deficit >4 mmol/L, fluid sequestration >6L): mild: two or fewer grave signs; severe: more than six grave signs.
Abbasinazari et al. [31] NA Mild: amylase concentration at least 3 times above upper limit of normal at more than 24 h after ERCP requiring admission for 2–3 d; moderate: admission for 4–10 d; severe: admission for more than 10 d

ERCP = endoscopic retrograde cholangiopancreatography, NA = not available, AST = asparate aminotransferase, BUN = blood urea nitrogen, SLDH/ALT = serum lactate dehydrogenate to alanine aminotransferase ratio, WBC = white blood cell.

Gu et al.

Gu et al. Nutrition Journal 2013 12:23   doi:10.1186/1475-2891-12-23

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