[Early postoperative hyperamylasemia after parathyroidectomy for primary hyperparathyroidism].
OBJECTIVE
The postoperative pancreatitis was a classical complication in the historical series of primary hyperparathyroidism (HPT), but the causal association was never demonstrated and even recent studies denied it. The aim of this study was to determine the augmentation of postoperative amylasemia, and its possible clinical traduction in patients operated for primary HPT.


METHODS
Fifty consecutive patients operated for cure of a primary HPT were included in this study. Total amylase, as well as isoenzyme fractions P (pancreatic) and S (salivary), calcium, phosphorus and intact PTH serum concentrations were determined on the days prior and after parathyroidectomy. Fifteen normocalcemic patients operated for secondary HPT constituted the control group.


RESULTS
The study deals with 42 female and eight male patients, their mean age was 58.5 years (range 19-89 years). All patients underwent parathyroidectomy for adenoma or hyperplasia. No patient had pancreatitis before parathyroidectomy. Postoperative amylasemia developed in four patients (8%), one with increased total amylase and P fraction, one with only increased total amylase, and two with increased total amylase and S fraction. No patients exhibited abdominal symptoms suggesting acute pancreatitis in the postoperative period. There was no correlation between pre- and post-operative calcium serum levels and pre- and post-operative amylasemia. In the secondary HPT group no significant diminution of the total amylasemia or of P and S fractions were observed.


CONCLUSIONS
These results indicate that acute pancreatitis is an exceptional postoperative complication of primary HPT nowadays. The 8% incidence reported in the present study matches the incidence of hyperamylasemia reported postoperatively in non-abdominal or non-parathyroid surgery.
Solis-Caxaj
C A
CA
Service de chirurgie générale et endocrinienne, hôpital Huriez, CHU de Lille, 59037 Lille, France. solisctz@hotmail.com
Jafari
M
M
Latteux
C
C
Galleri
D
D
Pattou
F
F
Carnaille
B
B
Franceschi
A
A
Proye
C
C
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000032:analysis / Q000097:blood; D002118:Calcium / Q000097:blood; D016022:Case-Control Studies; D015984:Causality; D005260:Female; D006801:Humans; D034321:Hyperamylasemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006961:Hyperparathyroidism / Q000209:etiology / Q000601:surgery*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D010281:Parathyroid Hormone / Q000097:blood; D016105:Parathyroidectomy / Q000009:adverse effects* / Q000379:methods; D010758:Phosphorus / Q000097:blood; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry; D013997:Time Factors
D010281:Parathyroid Hormone; D010758:Phosphorus; D000681:Amylases; D002118:Calcium