• Chih-Wei Tseng, Chun-Chia Chen, Shan-Zu Lin, Full-Young Chang, Han-Chieh Lin, and Shou-Dong Lee.
• Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
• Pancreas. 2011 Nov 1; 40 (8): 1211-4.

ObjectivesThe aim of this prospective study was to evaluate the diagnostic value of the rapid urinary trypsinogen-2 test strip in post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis.MethodsA total of 150 patients were tested with the urinary trypsinogen-2 test strip and serum levels of amylase and lipase before ERCP and 3 hours after ERCP. The diagnostic value of urinary trypsinogen-2 strip test compared with that of serum amylase and lipase was analyzed.ResultsPost-ERCP pancreatitis was diagnosed in 13 (8.7%) of 150 patients. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of urinary trypsinogen-2 dipstick test at 3 hours after ERCP are 84.6%, 97.1%, 73.3%, 98.5%, and 96%, respectively. At the cutoff level of 3 times the upper reference limit, the negative predictive values of amylase and lipase were comparable to that urinary trypsinogen-2 strip test; however, their positive predictive values (42.9% and 36.4%, respectively) were markedly lower than that of urinary trypsinogen-2 test (73.3%).ConclusionsThe urinary trypsinogen-2 dipstick test is a useful test for early diagnosis of post-ERCP pancreatitis. A negative urinary dipstick test at 3 hours after the procedure rules out post-ERCP pancreatitis with a high probability and allows of early discharge plan.

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