• Yu Zhang, Xiao-Ling Ye, and Xin-Yue Wan.
• Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei, China; Department of Gastroenterology, Henan Provincial People's Hospital, Zhengzhou, 450003, Henan, China.
• J Formos Med Assoc. 2024 Sep 17.

BackgroundPost-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains a major concern for clinicians. Hence early identification of PEP is meaningful to minimize medical risks.AimsThis study aims to explore the value of dynamic leukocyte changes for early prediction of PEP.MethodsPatients from January 2017 to December 2018 (training set) and January 2019 to December 2022 (test set) were retrospectively reviewed. The dynamic changes of leukocyte, neutrophil, and lymphocyte were examined to evaluate the diagnostic value of PEP.ResultsA total of 498 patients (36 PEP cases) in training set and 948 patients (71 PEP cases) in test set were analyzed. Four predictors were finally identified in training set containing margin and ratio of 3h-post ERCP leukocyte count (Po Leu) to pre-ERCP leukocyte count (Pr Leu), 3h post-ERCP neutrophil-to-lymphocyte ratio (NLR) and pre-ERCP fibrinogen levels. ROC analysis revealed the optimal thresholds were 2.3 (x109/L), 1.6, 4.8 and 3.1 (g/L), respectively. The sensitivity and specificity of Po Leu - Pr Leu and Po Leu/Pr Leu were 71.0%, 82.7%, 66.1% and 86.3% to diagnosis PEP in patients with hyperamylasemia.ConclusionsFor early identification of PEP, the elevation of amylase and lipase still exhibits the highest sensitivity, while the dynamic changes of leukocyte would be helpful for the different diagnosis of hyperamylasemia.Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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