The significance of hyperamylasaemia after colonic resection

Colonic resection may be complicated by prolonged post-operative paralytic ileus. Post-operative hyperamylasaemia and pancreatitis may sometimes follow abdominal surgery or occasionally trauma. Post-operative ileus seen after colectomy may be secondary to unrecognized pancreatitis and hyperamylasaemia. The aims of this study were to identify the incidence of hyperamylasaemia after colonic resection, to investigate the effect of hyperamylasaemia on post-operative intestinal function and to correlate any changes with extent of colorectal resection.

The serum amylase was determined prospectively in a consecutive series of 150 patients who underwent elective colorectal resection. Serum amylase was measured before surgery and post-operatively until it returned to within the normal range.

Hyperamylasaemia occurred in 28 patients (18.7%) after colorectal surgery. Serum amylase levels returned to normal in all but seven patients (4.7%) by the second post-operative day. The development of hyperamylasaemia did not adversely influence the post-operative course. Both groups of patients had similar restoration of intestinal function and were discharged home on equivalent days. Ligation of the middle colic artery alone was found to be significantly associated with hyperamylasaemia by multivariate stepwise logistic regression analysis.

Twenty-eight out of 150 patients who underwent colorectal resection developed hyperamylasaemia after surgery. The incidence was highest in patients with middle colic artery ligation. The development of post-operative hyperamylasaemia does not seem to influence adversely the post-operative course in this series.