Procalcitonin test as an indicator of the severity of acute biliary pancreatitis

The objective of this study was to investigate the use of the procalcitonin test as a marker for the severity of acute biliary pancreatitis.

Methods and materials. A retrospective study was conducted to assess the severity of acute biliary pancreatitis in 45 patients. The severity was determined by the presence and duration of organ failure, the severity of acute cholangitis, and pancreatic necrosis. CT scans were performed in 30 patients and markers of inflammation (procalcitonin, C-reactive protein, and leukocyte levels) were studied. Procalcitonin was assessed by chemiluminescence enzyme immunoassay, and the level above 0.5 ng/ml was considered positive.

Results. Organ failure was present in 22 of 45 patients and absent in the remaining 23. Among those with organ failure, 10 patients had severe acute cholangitis, 3 had pancreatic necrosis, and 9 had both acute cholangitis and necrosis. Three patients died. Without organ dysfunction, all 18 from 30 patients had interstitial pancreatitis, with 6 having no acute cholangitis, 10 having mild cholangitis, and 7 having moderate severity. ROC analysis data: area under the curve (AUC) for procalcitonin was 0.788, cut-off point was 0.6 ng/mL, sensitivity and specificity were 79 % and 76 % respectively, p-value was 0.001. For CRP, AUC was 0.524, cut-off point was 40 mg/L, sensitivity was 58 % and specificity was 61 %, p-value was 0.785. Leukocytes had an AUC of 0.594, with a cut-off of 10´10⁹/L, sensitivity was 58 % and specificity was 66 %, p-value was 0.265.

Conclusion. The procalcitonin test with a level of 0.6 ng/mL or higher has good diagnostic value in predicting organ failure in acute biliary pancreatitis patients, with greater sensitivity compared to CRP and leukocytes.

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