{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:39:02Z","timestamp":1789677542146,"version":"4.0.1"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Sumitomo Bakelite Corporation"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastroenterol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As trypsin activation occurs early in the pathogenesis of pancreatitis, evaluating serum trypsin (TRY) may allow immediate prediction of post-ERCP pancreatitis (PEP). This study aims to evaluate the diagnostic performance of TRY measurement for predicting PEP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter prospective observational study was conducted at 12 tertiary centers in Japan. Serum TRY, amylase (AMY), pancreatic-type AMY (P-AMY), and lipase (LIP) were measured before ERCP, immediately post-procedure (0\u00a0h), and 2\u00a0h post-procedure. Predictive performances of pancreatic enzymes for PEP were evaluated using receiver operating characteristic (ROC) analysis, Youden\u2019s index, and DeLong\u2019s test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PEP was identified in 48 of the 463 patients analyzed (10.3%). The optimal 0-h TRY cut-off was 2043\u00a0ng\/mL, yielding an area under the ROC curve (AUC) of 0.83 (68.7% sensitivity, 84.6% specificity), significantly higher than those of 0-h AMY (AUC 0.74,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), 0-h P-AMY (0.78,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), or 0-h LIP (0.80,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). At 2-h, TRY showed an AUC of 0.89, superior to 2-h\u00a0AMY (0.84) and comparable to 2-h\u00a0P-AMY (0.89) and 2-h\u00a0LIP (0.90). When cutoffs were set as 2\u2009\u00d7\u2009, 2.5\u2009\u00d7\u2009and 3\u2009\u00d7\u2009of the upper limit of normal, TRY consistently showed higher sensitivity than AMY or P-AMY. TRY showed the earliest and steepest post-procedural increase among all enzymes in patients with PEP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TRY measured immediately after ERCP provides significantly better early prediction of PEP than conventional enzymes. Rapid measurement of TRY may enable immediate risk stratification, potentially improving clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00535-026-02472-8","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:00:35Z","timestamp":1783404035000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Immediate prediction of post-ERCP pancreatitis: a novel approach using serum trypsin"],"prefix":"10.1007","author":[{"given":"Takashi","family":"Tamura","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Fujigaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Sanuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Sugimori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsukasa","family":"Ikeura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Emori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Fukatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Oka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Ikezawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoji","family":"Takada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanori","family":"Asada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayana","family":"Kishibuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Ogura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobu","family":"Nishioka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Shimatani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masataka","family":"Kano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arata","family":"Sakai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kae","family":"Nagao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Shintani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Inatomi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6885-9223","authenticated-orcid":false,"given":"Masayuki","family":"Kitano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"2472_CR1","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1111\/den.15004","volume":"37","author":"S Mukai","year":"2025","unstructured":"Mukai S, Takeyama Y, Itoi T, Ikeura T, Irisawa A, Iwasaki E, et al. 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