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Objectives: We aimed to clarify the clinical utility of measuring serum pancreatic enzymes after endoscopic retrograde cholangiopancreatography (ERCP) for the purpose of predicting post‐ERCP pancreatitis (PEP) by a meta‐analysis of diagnostic test accuracy studies. Methods: Studies on the prediction accuracy of PEP by serum amylase or lipase measured at 2, 3, and 4 h after ERCP were collected. A literature search was performed in PubMed and the Cochrane Library database for studies published between January 1980 and March 2023. The quality of individual studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies‐2. Data were analyzed using Meta‐DiSc 2.0 software. Results: We searched the databases and identified 20 observational studies (12,313 participants). PEPs were defined according to criteria by Cotton or modified Cotton, revised Atlanta criteria, or the Japanese criteria. Meta‐analysis of eight studies (4389 participants) showed a pooled sensitivity of 71.1% (95% confidence interval [CI] 56.1–82.5) and pooled specificity of 91.2% (95% CI 85.9–94.6) for the serum amylase cut‐off value at 3 times the upper limit of normal (ULN). Another meta‐analysis of five studies (1970 participants) showed a pooled sensitivity of 85.8% (95% CI 61.9–95.7) and pooled specificity of 85.3% (95% CI 81.9–88.1) for the serum lipase cut‐off value at 3 times ULN. Conclusion: Despite a high risk of bias due to various reference standards, this updated meta‐analysis and the utility assessment by a decision tree showed the utility of serum amylase or lipase levels more than 3 times ULN measured 2–4 h after ERCP for predicting PEP. [ABSTRACT FROM AUTHOR]

The article discusses a case of afferent loop syndrome following pancreatic head cancer surgery, which was treated with metal stent placement using a short-type single-balloon enteroscope. The patient, a 74-year-old woman, underwent surgery for pancreatic head cancer and developed afferent loop syndrome due to peritoneal dissemination. The syndrome was successfully treated endoscopically with drainage and stent placement, resulting in improved condition without complications. The use of balloon-assisted enteroscopy in such cases is highlighted as an alternative to invasive surgical treatment. [Extracted from the article]

Watch a video of this article. [ABSTRACT FROM AUTHOR]