title: Prophylactic administration of urinary trypsin inhibitor prevents postoperative hyperamylasemia after R2 gastrectomy in patients with gastric cancer. A prospective randomized trial.
abstract: The purpose of this prospective randomized study was to determine whether prophylactic administration of urinary trypsin inhibitor prevents postoperative damage to the pancreas caused by R2 gastrectomy in patients with gastric cancer, by analyzing related enzyme activities. Among the 22 patients who underwent distal partial gastrectomy together with R2 lymphadenectomy, 12 were given the drug for 3 days postoperatively, and 10 no therapeutic agent. These groups were otherwise comparable. Postoperatively, the control patients had significantly higher levels of total amylase activity in the serum and P-type amylase when compared to the preoperative data. These amylase activities almost remained at the preoperative level in those given the drug. When the ratio of increase in enzyme activities (postoperative value divided by preoperative value) were compared, on the 7th postoperative day, total amylase activity in the serum and P-type amylase were significantly different between the two groups (p less than 0.05). This difference was also evident when comparing total amylase activity in the urine (p less than 0.05). These findings indicate that prophylactic administration of urinary trypsin inhibitor would aid in preventing postoperative hyperamylasemia caused by R2 gastrectomy in patients with gastric cancer.
authors.affiliation: Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Korenaga
authors.forename: H
authors.initials: H
authors.lastname: Orita
authors.forename: Y
authors.initials: Y
authors.lastname: Kakeji
authors.forename: M
authors.initials: M
authors.lastname: Haraguchi
authors.forename: Y
authors.initials: Y
authors.lastname: Maehara
authors.forename: K
authors.initials: K
authors.lastname: Sugimachi
mesh_terms: D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006023:Glycoproteins / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010741:Phospholipases A / Q000097:blood; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D014359:Trypsin Inhibitor, Kazal Pancreatic / Q000097:blood; D014361:Trypsin Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D006023:Glycoproteins; D014361:Trypsin Inhibitors; D014359:Trypsin Inhibitor, Kazal Pancreatic; D010741:Phospholipases A; D000681:Amylases; C028665:urinastatin