Acute pancreatitis after abdominal vascular surgery

Retroperitoneal dissection and ischemia have been proposed as risk factors for postoperative pancreatitis. Although both are routine components of abdominal vascular operations, postoperative pancreatitis has not been adequately evaluated in vascular patients. The purpose of this study was to determine the incidence and outcomes of pancreatitis after abdominal vascular surgery.

We collected pre-, intra-, and postoperative data on 21 patients who developed pancreatitis after abdominal vascular operations. For comparison, we studied 21 age- and gender-matched case controls undergoing identical operations during the same period.

The incidence of pancreatitis among all patients undergoing abdominal vascular operations during the 6-year study period was 1.8%. Pancreatitis was diagnosed 9.8 +/- 8 days after operation and was associated with 3 or less Ranson signs in all 21 study subjects. The following outcomes data differed between the two groups: duration of npo (9 +/- 6 days for subjects versus 3.9 +/- 2 days for controls, p < 0.001) and need for parenteral nutrition (13 subjects versus no controls, p < 0.00 1). Although there was a trend towards longer hospitalization in the subjects (16 +/- 12 days versus 11 +/- 8 days, p = 0.08), there was no difference in complication rates between the two groups. Sixteen subjects (76%) had no complications. Three developed severe complications, two of whom died of causes unrelated to pancreatitis. One developed a pseudocyst that resolved spontaneously. Cholelithiasis was a causative factor in 2 subjects; no cause was established in the remaining 19. There was no difference in operative details between the two groups.

These data indicate that pancreatitis is a rare and self-limited complication of abdominal vascular surgery. Our findings suggest that pancreatitis is costly and inconvenient but rarely serious after abdominal vascular operations.