Immediate prediction of post-ERCP pancreatitis: a novel approach using serum trypsin - Scorecard - MDSpire

Immediate prediction of post-ERCP pancreatitis: a novel approach using serum trypsin

  • By

  • Takashi Tamura

  • Seiji Fujigaki

  • Tsuyoshi Sanuki

  • Tetsuya Ikeda

  • Satoshi Sugimori

  • Tsukasa Ikeura

  • Shinji Nakayama

  • Tomoya Emori

  • Kazuhiro Fukatsu

  • Yasutaka Ishii

  • Shiro Oka

  • Kenji Ikezawa

  • Ryoji Takada

  • Masanori Asada

  • Ayana Kishibuchi

  • Takeshi Ogura

  • Nobu Nishioka

  • Masaaki Shimatani

  • Masataka Kano

  • Arata Sakai

  • Kae Nagao

  • Shuhei Shintani

  • Osamu Inatomi

  • Masayuki Kitano

  • July 7, 2026

  • 0 min

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Clinical Scorecard: Rapid Assessment of Post-ERCP Pancreatitis Risk: Innovative Use of Serum Trypsin Levels

At a Glance

CategoryDetail
ConditionPost-ERCP pancreatitis (PEP)
Key MechanismsElevated pancreatic ductal pressure during ERCP leads to premature activation of trypsinogen to trypsin, triggering pancreatic inflammation.
Target PopulationPatients scheduled for ERCP aged ≥ 20 years with an intact papilla.
Care SettingMulticenter observational study across major hospitals.

Key Highlights

  • PEP occurs in approximately 5–15% of ERCP cases.
  • Serum trypsin levels may allow earlier detection of PEP compared to traditional pancreatic enzymes.
  • The study involved 12 major hospitals in Japan to enhance the sample size and rigor.

Guideline-Based Recommendations

Diagnosis

  • Measure serum trypsin levels immediately after ERCP for early prediction of PEP.

Management

  • Standard intravenous fluid administration post-ERCP until the following morning.

Monitoring & Follow-up

  • Assess occurrence of PEP within 12–24 hours following ERCP.

Risks

  • Severe PEP may require ICU admission and can be life-threatening.

Patient & Prescribing Data

Patients undergoing ERCP without prior history of sphincterotomy or papillary interventions.

Patients with abdominal pain post-ERCP should undergo immediate CT evaluation.

Clinical Best Practices

  • Collect and analyze blood samples for pancreatic enzymes promptly after ERCP.
  • Ensure informed consent is obtained from all participants prior to enrollment.

Related Resources & Content

Original Source(s)

Immediate prediction of post-ERCP pancreatitis: a novel approach using serum trypsin

  • by Takashi Tamura, Seiji Fujigaki, Tsuyoshi Sanuki, Tetsuya Ikeda, Satoshi Sugimori, Tsukasa Ikeura, Shinji Nakayama, Tomoya Emori, Kazuhiro Fukatsu, Yasutaka Ishii, Shiro Oka, Kenji Ikezawa, Ryoji Takada, Masanori Asada, Ayana Kishibuchi, Takeshi Ogura, Nobu Nishioka, Masaaki Shimatani, Masataka Kano, Arata Sakai, Kae Nagao, Shuhei Shintani, Osamu Inatomi, Masayuki Kitano

  • July 7, 2026

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