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Amylase creatinine clearance ratio after biliary surgery
Gut
|January 1, 1977
Summary
The amylase creatinine clearance ratio (ACCR) is a more sensitive indicator of pancreatic damage after gallbladder surgery than standard amylase tests. ACCR detected issues in 28% of patients, even when serum amylase levels were normal.
Area of Science:
- Biochemistry
- Gastroenterology
- Surgical Research
Background:
- The amylase creatinine clearance ratio (ACCR) is recognized for its higher sensitivity in diagnosing acute pancreatitis compared to serum amylase.
- Biliary surgery, such as cholecystectomy, can potentially lead to pancreatic gland injury.
Purpose of the Study:
- To evaluate the utility of serial amylase creatinine clearance ratio (ACCR) estimations in detecting postoperative pancreatic gland damage following elective cholecystectomy.
- To compare the sensitivity of ACCR with serum amylase levels in identifying pancreatic injury after biliary surgery.
Main Methods:
- Serial ACCR measurements were performed on 25 patients undergoing elective cholecystectomy.
- Biochemical evidence of pancreatic damage was assessed using established criteria.
- Serum amylase levels were monitored concurrently.
Main Results:
- Biochemical evidence of pancreatic gland damage was observed in 28% of patients postoperatively.
- This pancreatic damage was detected by ACCR even when serum amylase levels remained within the normal range.
- Elevated ACCR was particularly pronounced in patients who underwent exploration of the common bile duct.
Conclusions:
- The amylase creatinine clearance ratio (ACCR) is a more sensitive marker for detecting pancreatic gland disruption secondary to biliary surgery than the serum amylase level.
- ACCR can identify subclinical pancreatic injury following cholecystectomy, especially when common bile duct exploration is performed.
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