Should serum pancreatic lipase replace serum amylase as a biomarker of acute pancreatitis?
GROUND: Serum pancreatic lipase may improve the diagnosis of pancreatitis compared to serum amylase. Both enzymes have been measured simultaneously at our hospital allowing for a comparison of their diagnostic accuracy. METHODS: Seventeen thousand five hundred and thirty-one measurements of either serum amylase and or serum pancreatic lipase were made on 10 931 patients treated at a metropolitan teaching hospital between January 2001 and May 2003. Of these, 8937 were initially treated in the Emergency Department. These results were collected in a database, which was linked by the patients’ medical record number to the radiology and medical records. Patients with either an elevated lipase value or a discharge diagnosis of acute pancreatitis had their radiological diagnosis reviewed along with their biochemistry and histology record. The diagnosis of acute pancreatitis was made if there was radiological evidence of peripancreatic inflammation. RESULTS: One thousand eight hundred and twen