Alanino aminotrasferasa en pancreatitis aguda de origen biliar
La pancreatitis aguda (PA) es una enfermedad de alta prevalencia e impacto socioeconómico. En nuestro medio la causa principal es la patología biliar. La ultrasonografía endoscópica no siempre está disponible dado su alto costo. Los niveles de alaninoaminotransferasa (ALT) mayores de 150 UI/1 se han relacionado con patología obstructiva de la vía biliar. Objetivo: determinar las características de la ALT en nuestra población para diagnosticar el origen biliar de la PA. Materialesy métodos: estudio de corte transversal en el Hospital de San José de Bogotá DC. Se revisaron historias clínicas con diagnóstico de PA de agosto 2010 a marzo 2012. Se analizaron datos sociodemográficos, clínicos, de laboratorio, imagenológicos, hallazgos intraoperat... Ver más
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FUNDACIÓN UNIVERSITARIA DE CIENCIA DE LA SALUD |
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https://nuevo.metarevistas.org/FUNDACIONUNIVERSITARIADECIENCIADELASALUD/logo.png |
| country_str |
Colombia |
| collection |
Revista Repertorio de Medicina y Cirugía |
| title |
Alanino aminotrasferasa en pancreatitis aguda de origen biliar |
| spellingShingle |
Alanino aminotrasferasa en pancreatitis aguda de origen biliar Aldana Dimas, Guillermo Eduardo Lleras Riaño, Juan David Acero Fagua, Fanny Pabón Parra, Manuel Guillermo pancreatitis aguda pronóstico coledocolitiasis colecistectomía alanino transaminasa (ALT) choledocolithiasis cholecystectomy acute pancreatitis prognosis alanine transaminase (ALT) |
| title_short |
Alanino aminotrasferasa en pancreatitis aguda de origen biliar |
| title_full |
Alanino aminotrasferasa en pancreatitis aguda de origen biliar |
| title_fullStr |
Alanino aminotrasferasa en pancreatitis aguda de origen biliar |
| title_full_unstemmed |
Alanino aminotrasferasa en pancreatitis aguda de origen biliar |
| title_sort |
alanino aminotrasferasa en pancreatitis aguda de origen biliar |
| title_eng |
Alanine aminotransferase in biliary acute pancreatitis |
| description |
La pancreatitis aguda (PA) es una enfermedad de alta prevalencia e impacto socioeconómico. En nuestro medio la causa principal es la patología biliar. La ultrasonografía endoscópica no siempre está disponible dado su alto costo. Los niveles de alaninoaminotransferasa (ALT) mayores de 150 UI/1 se han relacionado con patología obstructiva de la vía biliar. Objetivo: determinar las características de la ALT en nuestra población para diagnosticar el origen biliar de la PA. Materialesy métodos: estudio de corte transversal en el Hospital de San José de Bogotá DC. Se revisaron historias clínicas con diagnóstico de PA de agosto 2010 a marzo 2012. Se analizaron datos sociodemográficos, clínicos, de laboratorio, imagenológicos, hallazgos intraoperatorios y diagnóstico etiológico. Resultados: se reclutaron 106 pacientes, 67% mujeres. Se estableció por análisis ROC que los niveles de ALT mayores de 74 UI/1 fueron más sensibles y específicos que los de 150 UI/1. Se encontró la relación de ALT mayor de 74 UI/1 con hiperbilirrubinemia, ictericia y hallazgos ecográficos compatibles con etiología biliar. Conclusión: existe significancia estadística para ALT mayor a 74 UI/1 con etiología biliar (sensibilidad 89%, especificidad 71%) con p <0.001. Se requieren estudios que comparen esta prueba diagnóstica con ultrasonografía endoscópica.
|
| description_eng |
Acute pancreatitis (AP) exhibits high prevalence and high social and economic impact. It is mainly of biliary etiology in our setting. Endoscopic ultrasonography is not always available due to its high costs. Alanine aminotransferase (ALT) Ievels greater than 150 UI/1 have been related to biliary duct obstruction. Objective: to determine ALT features among our population to establish biliary etiology. Materials and Methods: a cross sectional study at Hospital de San José, Bogotá DC. The medica) records of all patients with AP from August 2010 to March 2012 were reviewed. Social, demographic, clinical, laboratory, imaging, intraoperative findings and etiologic diagnosis data were analyzed. Results: 106 patients were recruited, 67% females. An ROC analysis established that at ALT Ievels greater than 74 IU/1 there was greater sensibility and specificity than at ALT Ievels of 150 IU/1. The relation between greater than 74 UI/1 ALT levels with hyperbilirrubinemia, jaundice and ultrasonographic findings compatible with biliary etiology was found. Conclusion: there is statistically significant correlations between ALT Ievels greater than 74UI/I and biliary etiology (sensibility 89 %, specificity 71 %), p <0.001. Further studies comparing this diagnostic test with endoscopic ultrasonography are required.
|
| author |
Aldana Dimas, Guillermo Eduardo Lleras Riaño, Juan David Acero Fagua, Fanny Pabón Parra, Manuel Guillermo |
| author_facet |
Aldana Dimas, Guillermo Eduardo Lleras Riaño, Juan David Acero Fagua, Fanny Pabón Parra, Manuel Guillermo |
| topicspa_str_mv |
pancreatitis aguda pronóstico coledocolitiasis colecistectomía alanino transaminasa (ALT) |
| topic |
pancreatitis aguda pronóstico coledocolitiasis colecistectomía alanino transaminasa (ALT) choledocolithiasis cholecystectomy acute pancreatitis prognosis alanine transaminase (ALT) |
| topic_facet |
pancreatitis aguda pronóstico coledocolitiasis colecistectomía alanino transaminasa (ALT) choledocolithiasis cholecystectomy acute pancreatitis prognosis alanine transaminase (ALT) |
| citationvolume |
22 |
| citationissue |
2 |
| citationedition |
Núm. 2 , Año 2013 : Abril – Junio |
| publisher |
Sociedad de Cirugía de Bogotá, Hospital de San José y Fundación Universitaria de Ciencias de la Salud |
| ispartofjournal |
Revista Repertorio de Medicina y Cirugía |
| source |
https://revistas.fucsalud.edu.co/index.php/repertorio/article/view/858 |
| language |
Español |
| format |
Article |
| rights |
https://creativecommons.org/licenses/by-nc-sa/4.0/ info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 |
| references |
Uhl W, Muller CA, Krahenbuhl L, Schmid SW, Scholzel S, Buchler MW. Acute gallstone pancreatitis: timing of laparoscopic cholecystectomy in mild and severe disease. Surg Endose. 1999 Nov;( l 1):1070-6. 2. Nieto J. Rodriguez S. Manejo de la pancreatitis aguda: guía de práctica clínica basada en la mejor infom1ación disponible. Rev Colomb Cir. 2010;25:76-96 3. Stabuc B, Drobne D, Ferkolj 1, Gruden A, Jereb J, Kolar G, et al. Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound. Eur J Gastroenterol Hepatol. 2008 Dec;20(12):1171-5. 4. Cappell MS. Acute pancreatitis: etiology, clinical presentation. diagnosis, and therapy. Med Clin N Am. 2008 Jul;(4):889-x. 5. Saraswat VA, Sharma BC, Agarwal DK, Kumar R, Negi TS, Tandon RK. Biliary microlithiasis in patients with idiopathic acule pancreatitis and un explained biliary pain: response to therapy. J Gastroenterol Hepatol. 2004 Oct;19(10):1206-11. 6. Kaw M. Brodmerkel GJ, Jr. ERCP, biliary crystal analysis, and sphincter of Oddi manometry in idiopathic recurrent paocreatitis. Gastrointest Endose. 2002 Feb;55(2):157-62. Anderson K, Brown LA, Daniel P, Connor SJ. Alanine transaminase rather than abdominal ultrasound alone is an importaot investigation to justify chole cystectomy in patients presenting with acule pancreatitis. HPB (Oxford). 2010 Jun;12(5):342-7. 8. Alexakis N, Lombard M, Raraty M, Ghaneh P, Smart HL, Gilmore 1, et al. When is pancreatitis considered to be of biliary origin and what are the implications far management?. Pancreatology. 2007: 7(2-3):131-41. 9. Kiriyama S. Gabata T, Takada T, Hirata K, Yoshida M, Mayumi T, et al. New diagnostic criteria of acure pancreatitis. J Hepatobiliary Pancreat Sci. 2010 Jan;(1):24-36. 10. Kalloo AN, Kantsevoy SV. Gallstones and biliary disease. Prim Care. 2001 Sep;28(3):591-606 1 l. Chak A. Hawes RH, Cooper OS, Hoffman B, Catalana MF. Wong RC, et al. Prospective assessment of the utility of EUS in the evaluation of gallstone pan creatitis. Gastrointest Endosc.1999 May;(5):599-604. 12. Ainsworth AP, Rafaelsen SR, Wamberg PA, Pless T, Durup J, Mortensen MB. Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholan giopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease. Scand J Gastroenterol. 2004 Jun;(6):579-83. 13. Smotkin J, Tenner S. Laboratory diagnostic tests in acute pancreatitis. J Clin Gastroenterol. 2002 Apr;(4):459-62. 14. Liu CL, Fan ST, Lo CM, Tso WK, Wong Y, Poon RT, et al. Clinico-biochemical prediction of biliary cause of acule pancreatitis in the era of endoscopic ultraso nography. Aliment Pharmacol Ther. 2005 Sep 1;(5):423-31. 15. Levy P, Boruchowicz A, Hastier P. Pariente A, Thevenot T. Frossard JL. et al. Diagnosticcriteria in predicting a biliary origin of acule pancreatitis in the era of endoscopic ultrasound: multicentre prospective evaluation of 213 patients. Pan creatology. 2005;(4-5):450-6. 16. Dholakia K, Pitchumoni CS, Agarwal N. How often are liver function tests nor mal in acute biliary pancreatitis?. J Clin Gastroenterol. 2004 Jan;(1):81-3. 17. Raraty MG, Finch M, Neoptolemos JP. Acute cholangitis and pancreatitis se condary to common duct stones: management update. World J Surg. 1998 Nov;(l l):1155-61. 18. Wang SS, Lin XZ, Tsai YT, Lee SD, Pan HB, Chou YH, et al. Clinical signifi cance of ultrasonography, computed tomography, and biochemical tests in the rapid diagnosis of gallstone-related pancreatitis: a prospective study. Pancreas. 1988;(2):153-8. 19. Chwistek M, Roberts 1, Amoateng-Adjepong Y. Gallstone pancreatitis: a com munity 1eaching hospital experience. J Clin Gastroenterol. 2001 Jul;( l):41-4. 20. Alexakis N, Neoptolemos JP. Algorithm for the diagnosis and Lreatment of acule biliary pancreatitis. Scand J Surg. 2005;94(2):124-9.. 21. Matull WR, Pereira SP, O'Donohue JW. Biochemical markers of acute pancrea titis. J Clin Pathol. 2006 Apr;(4):340-4. 22. Kemppainen E, Puolakkainen P. Non-alcoholic etiologies of acute pancreatitis exclusion of other etiologic factors besides alcohol and gallstoncs. Pancreatolo gy. 2007:(2-3):142-6. 23. Stimac D, Rubinic M, Lenac T, Kovac D, Vcev A, Miletic D. Biochemical pa rameters in the early differentiation of the etiology of acute pancreatitis. Am J Gastroenterol. 1996 Nov;9 1(11):2355-9. 24. Folsch UR, Nitsche R, Ludtke R, Hilgers RA, Creutzfeldt W. Early ERCP and papillotomy compared with conservative treatment for acule biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med. 1997 Jan 23;(4):237-42. 25. Sanjay P, Yeeting S, Whigham C. Judson HK, Kulli C, Polignano FM, et al. Managemenl guidelines for gallstone pancreatitis.Are the targets achievable?. J Pancreas. 2009;(1):43-7. 26. Kimura Y, Takada T, Kawarada Y. Hirata K, Mayumi T, Yoshida M, et al. JPN Guidelines for the management of acute pancreatitis: treatment of gallstone-in duced acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006;(1):56-60. 27. Graham DF, Wyllie FJ. Prediction of gall-stone pancreatitis by computer. Br Med J. 1979 Feb 24;1(6162):515-7. 28. Campbell EJ, Montgomery DA, Mackay CJ. A national survey of current surgical treatment of acute gallstone disease. Surg Laparosc Endose Percutan Tech. 2008 Jun;(3):242-7. 29. Kaw M. AI-Antably Y,Kaw P. Management of gallstone pancreatitis: cholecys tectomy or ERCP and endoscopic sphincterotomy.Gastrointest Endose. 2002 Jul;56(1):61-5. |
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Alanino aminotrasferasa en pancreatitis aguda de origen biliar info:eu-repo/semantics/article application/pdf Sociedad de Cirugía de Bogotá, Hospital de San José y Fundación Universitaria de Ciencias de la Salud Revista Repertorio de Medicina y Cirugía https://revistas.fucsalud.edu.co/index.php/repertorio/article/view/858 Español https://creativecommons.org/licenses/by-nc-sa/4.0/ Uhl W, Muller CA, Krahenbuhl L, Schmid SW, Scholzel S, Buchler MW. Acute gallstone pancreatitis: timing of laparoscopic cholecystectomy in mild and severe disease. Surg Endose. 1999 Nov;( l 1):1070-6. 2. Nieto J. Rodriguez S. Manejo de la pancreatitis aguda: guía de práctica clínica basada en la mejor infom1ación disponible. Rev Colomb Cir. 2010;25:76-96 3. Stabuc B, Drobne D, Ferkolj 1, Gruden A, Jereb J, Kolar G, et al. Acute biliary pancreatitis: detection of common bile duct stones with endoscopic ultrasound. Eur J Gastroenterol Hepatol. 2008 Dec;20(12):1171-5. 4. Cappell MS. Acute pancreatitis: etiology, clinical presentation. diagnosis, and therapy. Med Clin N Am. 2008 Jul;(4):889-x. 5. Saraswat VA, Sharma BC, Agarwal DK, Kumar R, Negi TS, Tandon RK. Biliary microlithiasis in patients with idiopathic acule pancreatitis and un explained biliary pain: response to therapy. J Gastroenterol Hepatol. 2004 Oct;19(10):1206-11. 6. Kaw M. Brodmerkel GJ, Jr. ERCP, biliary crystal analysis, and sphincter of Oddi manometry in idiopathic recurrent paocreatitis. Gastrointest Endose. 2002 Feb;55(2):157-62. Anderson K, Brown LA, Daniel P, Connor SJ. Alanine transaminase rather than abdominal ultrasound alone is an importaot investigation to justify chole cystectomy in patients presenting with acule pancreatitis. HPB (Oxford). 2010 Jun;12(5):342-7. 8. Alexakis N, Lombard M, Raraty M, Ghaneh P, Smart HL, Gilmore 1, et al. When is pancreatitis considered to be of biliary origin and what are the implications far management?. Pancreatology. 2007: 7(2-3):131-41. 9. Kiriyama S. Gabata T, Takada T, Hirata K, Yoshida M, Mayumi T, et al. New diagnostic criteria of acure pancreatitis. J Hepatobiliary Pancreat Sci. 2010 Jan;(1):24-36. 10. Kalloo AN, Kantsevoy SV. Gallstones and biliary disease. Prim Care. 2001 Sep;28(3):591-606 1 l. Chak A. Hawes RH, Cooper OS, Hoffman B, Catalana MF. Wong RC, et al. Prospective assessment of the utility of EUS in the evaluation of gallstone pan creatitis. Gastrointest Endosc.1999 May;(5):599-604. 12. Ainsworth AP, Rafaelsen SR, Wamberg PA, Pless T, Durup J, Mortensen MB. Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholan giopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease. Scand J Gastroenterol. 2004 Jun;(6):579-83. 13. Smotkin J, Tenner S. Laboratory diagnostic tests in acute pancreatitis. J Clin Gastroenterol. 2002 Apr;(4):459-62. 14. Liu CL, Fan ST, Lo CM, Tso WK, Wong Y, Poon RT, et al. Clinico-biochemical prediction of biliary cause of acule pancreatitis in the era of endoscopic ultraso nography. Aliment Pharmacol Ther. 2005 Sep 1;(5):423-31. 15. Levy P, Boruchowicz A, Hastier P. Pariente A, Thevenot T. Frossard JL. et al. Diagnosticcriteria in predicting a biliary origin of acule pancreatitis in the era of endoscopic ultrasound: multicentre prospective evaluation of 213 patients. Pan creatology. 2005;(4-5):450-6. 16. Dholakia K, Pitchumoni CS, Agarwal N. How often are liver function tests nor mal in acute biliary pancreatitis?. J Clin Gastroenterol. 2004 Jan;(1):81-3. 17. Raraty MG, Finch M, Neoptolemos JP. Acute cholangitis and pancreatitis se condary to common duct stones: management update. World J Surg. 1998 Nov;(l l):1155-61. 18. Wang SS, Lin XZ, Tsai YT, Lee SD, Pan HB, Chou YH, et al. Clinical signifi cance of ultrasonography, computed tomography, and biochemical tests in the rapid diagnosis of gallstone-related pancreatitis: a prospective study. Pancreas. 1988;(2):153-8. 19. Chwistek M, Roberts 1, Amoateng-Adjepong Y. Gallstone pancreatitis: a com munity 1eaching hospital experience. J Clin Gastroenterol. 2001 Jul;( l):41-4. 20. Alexakis N, Neoptolemos JP. Algorithm for the diagnosis and Lreatment of acule biliary pancreatitis. Scand J Surg. 2005;94(2):124-9.. 21. Matull WR, Pereira SP, O'Donohue JW. Biochemical markers of acute pancrea titis. J Clin Pathol. 2006 Apr;(4):340-4. 22. Kemppainen E, Puolakkainen P. Non-alcoholic etiologies of acute pancreatitis exclusion of other etiologic factors besides alcohol and gallstoncs. Pancreatolo gy. 2007:(2-3):142-6. 23. Stimac D, Rubinic M, Lenac T, Kovac D, Vcev A, Miletic D. Biochemical pa rameters in the early differentiation of the etiology of acute pancreatitis. Am J Gastroenterol. 1996 Nov;9 1(11):2355-9. 24. Folsch UR, Nitsche R, Ludtke R, Hilgers RA, Creutzfeldt W. Early ERCP and papillotomy compared with conservative treatment for acule biliary pancreatitis. The German Study Group on Acute Biliary Pancreatitis. N Engl J Med. 1997 Jan 23;(4):237-42. 25. Sanjay P, Yeeting S, Whigham C. Judson HK, Kulli C, Polignano FM, et al. Managemenl guidelines for gallstone pancreatitis.Are the targets achievable?. J Pancreas. 2009;(1):43-7. 26. Kimura Y, Takada T, Kawarada Y. Hirata K, Mayumi T, Yoshida M, et al. JPN Guidelines for the management of acute pancreatitis: treatment of gallstone-in duced acute pancreatitis. J Hepatobiliary Pancreat Surg. 2006;(1):56-60. 27. Graham DF, Wyllie FJ. Prediction of gall-stone pancreatitis by computer. Br Med J. 1979 Feb 24;1(6162):515-7. 28. Campbell EJ, Montgomery DA, Mackay CJ. A national survey of current surgical treatment of acute gallstone disease. Surg Laparosc Endose Percutan Tech. 2008 Jun;(3):242-7. 29. Kaw M. AI-Antably Y,Kaw P. Management of gallstone pancreatitis: cholecys tectomy or ERCP and endoscopic sphincterotomy.Gastrointest Endose. 2002 Jul;56(1):61-5. http://purl.org/coar/resource_type/c_6501 Núm. 2 , Año 2013 : Abril – Junio http://purl.org/coar/resource_type/c_2df8fbb1 http://purl.org/redcol/resource_type/ART info:eu-repo/semantics/publishedVersion http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 Text Artículo de revista Publication 2 22 La pancreatitis aguda (PA) es una enfermedad de alta prevalencia e impacto socioeconómico. En nuestro medio la causa principal es la patología biliar. La ultrasonografía endoscópica no siempre está disponible dado su alto costo. Los niveles de alaninoaminotransferasa (ALT) mayores de 150 UI/1 se han relacionado con patología obstructiva de la vía biliar. Objetivo: determinar las características de la ALT en nuestra población para diagnosticar el origen biliar de la PA. Materialesy métodos: estudio de corte transversal en el Hospital de San José de Bogotá DC. Se revisaron historias clínicas con diagnóstico de PA de agosto 2010 a marzo 2012. Se analizaron datos sociodemográficos, clínicos, de laboratorio, imagenológicos, hallazgos intraoperatorios y diagnóstico etiológico. Resultados: se reclutaron 106 pacientes, 67% mujeres. Se estableció por análisis ROC que los niveles de ALT mayores de 74 UI/1 fueron más sensibles y específicos que los de 150 UI/1. Se encontró la relación de ALT mayor de 74 UI/1 con hiperbilirrubinemia, ictericia y hallazgos ecográficos compatibles con etiología biliar. Conclusión: existe significancia estadística para ALT mayor a 74 UI/1 con etiología biliar (sensibilidad 89%, especificidad 71%) con p <0.001. Se requieren estudios que comparen esta prueba diagnóstica con ultrasonografía endoscópica. Aldana Dimas, Guillermo Eduardo Lleras Riaño, Juan David Acero Fagua, Fanny Pabón Parra, Manuel Guillermo pancreatitis aguda pronóstico coledocolitiasis colecistectomía alanino transaminasa (ALT) choledocolithiasis cholecystectomy acute pancreatitis prognosis Journal article Acute pancreatitis (AP) exhibits high prevalence and high social and economic impact. It is mainly of biliary etiology in our setting. Endoscopic ultrasonography is not always available due to its high costs. Alanine aminotransferase (ALT) Ievels greater than 150 UI/1 have been related to biliary duct obstruction. Objective: to determine ALT features among our population to establish biliary etiology. Materials and Methods: a cross sectional study at Hospital de San José, Bogotá DC. The medica) records of all patients with AP from August 2010 to March 2012 were reviewed. Social, demographic, clinical, laboratory, imaging, intraoperative findings and etiologic diagnosis data were analyzed. Results: 106 patients were recruited, 67% females. An ROC analysis established that at ALT Ievels greater than 74 IU/1 there was greater sensibility and specificity than at ALT Ievels of 150 IU/1. The relation between greater than 74 UI/1 ALT levels with hyperbilirrubinemia, jaundice and ultrasonographic findings compatible with biliary etiology was found. Conclusion: there is statistically significant correlations between ALT Ievels greater than 74UI/I and biliary etiology (sensibility 89 %, specificity 71 %), p <0.001. Further studies comparing this diagnostic test with endoscopic ultrasonography are required. Alanine aminotransferase in biliary acute pancreatitis alanine transaminase (ALT) 2013-06-01T00:00:00Z 2013-06-01T00:00:00Z 10.31260/RepertMedCir.v22.n2.2013.858 https://doi.org/10.31260/RepertMedCir.v22.n2.2013.858 0121-7372 https://revistas.fucsalud.edu.co/index.php/repertorio/article/download/858/890 2462-991X 113 108 2013-06-01 |