Radiology, Vol 178, 343-346, Copyright © 1991 by Radiological Society of North America
Pancreatic response to percutaneous biliary drainage: a prospective study
SJ Savader, AC Venbrux, KV Robbins, AM Gittelsohn and FA Osterman
Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Hospital, Baltimore, MD 21205.
To evaluate the effects of percutaneous biliary drainage (PBD) on the
pancreas, serum amylase levels were measured for 7 consecutive days after
PBD and compared with baseline values in 50 patients who underwent a total
of 53 PBD procedures. Of the 45 patients with normal baseline serum amylase
levels, 12 patients (24%) developed postprocedural hyperamylasemia without
clinical symptoms and five patients (10%) developed postprocedural
hyperamylasemia with clinical signs of pancreatitis. Five patients who
presented with elevated baseline serum amylase levels demonstrated
decreases into the normal range after placement of stents without
initiation of bowel rest or liquid diet. The level of biliary obstruction
proved insignificant, as did the nature of the obstructing disease, in
determining which patients would experience hyperamylasemia or pancreatitis
after PBD. It is concluded that the frequency of pancreatic insult from PBD
may be more common than previously reported and that patient susceptibility
is not dependent on the level of biliary obstruction or the nature of the
disease.
