Serum Amylase elevation following hepatic resection in patients with chronic liver disease.
BACKGROUND
Factors liable to cause hyperamylasemia after hepatectomy were studied retrospectively in 140 patient with chronic liver disease.


METHODS
The pringle maneuver was performed in 113 patients (Pringle group), the hemihepatic vascular occlusion technique in 21 (hemihepatic group), and no vascular occlusion in 6 (no-occlusion group).


RESULTS
In the Pringle group, postoperative serum amylase levels were elevated significantly in comparison with the preoperative levels, but were not elevated in hemihepatic and no-occlusions groups. In the Pringle group, there were 4 patients whose postoperative serum amylase levels exceeded 3.5 times the upper limit of the normal range together with serum pancreatic isoamylase or lipase elevation or both. When compared with the other 109 patients, these 4 patients had a significantly longer vascular occlusion time (51 +/-3 minutes versus 94 +/- 8 minutes P<0.005). One of them developed pancreatitis and died from hepatic failure.


CONCLUSIONS
Prolongation of portal congestion carries a potential risk of serum amylase elevation and pancreatitis after hepatectomy in patients with underlying liver disease.
Miyagawa
S
S
First Department of Surgery, Shinshu University, School of Medicine, Matsumoto, Japan.
Makuuchi
M
M
Kawasaki
S
S
Kakazu
T
T
Hayashi
K
K
Kasai
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood*; D002908:Chronic Disease; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000209:etiology; D011183:Postoperative Complications / Q000097:blood; D011184:Postoperative Period; D012189:Retrospective Studies
D000681:Amylases