Despite the widespread use of the serum amylase determination, acute pancreatitis is frequently mistaken for other acute surgical conditions. An elevated serum amylase level may not be present when the patient is seen soon after the onset of the illness. Unnecessary laparotomy may be the result, with no benefit and often detriment to the patient.
Elevated serum lipase values are reputed to appear later in the course of acute pancreatitis and to persist longer than the serum amylase elevations. However, little clinical use has been made of this test. In the past, failure to use the lipase determination may have been due to the unreliability of the methods in common use.
Until recently, most serum lipase determinations were based on the Cherry-Crandall technique which uses olive oil as a substrate and requires titrimetric determination of the fatty acid released by enzymatic hydrolysis. Unfortunately, the olive oil substrate is acted upon
PANCREATIC LIPASE IN ACUTE PANCREATITIS. JAMA. 1966;196(7):657. doi:10.1001/jama.1966.03100200097031