Comprehensive Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
Department of Gastroenterology, Shiga University of Medical Science, Otsu, Japan.
Dig Endosc. 2015 Sep;27(6):674-8. doi: 10.1111/den.12449. Epub 2015 Mar 4.
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.
球囊辅助式小肠镜检查后发生的胰腺炎是一种罕见但严重的并发症。其发病机制尚不确定，也没有确立预防策略。我们进行了一项回顾性研究，旨在阐明胰性高淀粉酶血症的危险因素。
本研究纳入了 84 例行经口单气囊小肠镜检查（SBE）的患者。在内镜检查后 2 小时测量血清胰腺和唾液淀粉酶水平。
我们观察到 3 例 SBE 后胰腺炎患者。预测胰性高淀粉酶血症的因素有：（i）老年患者；（ii）更深的插入；和（iii）顺时针插入。相反，检查时年龄较小是唾液性高淀粉酶血症的一个显著因素。
在进行 SBE 后，测量胰淀粉酶而非总淀粉酶非常重要。进行经口 SBE 时，特别是当镜身呈顺时针环行或患者为老年时，应减少插入的距离。
