Elevated Liver Enzymes Can Predict Complications Early After Pancreatic Resection

Area of Science:

• Hepatology
• Gastroenterology
• Surgical Outcomes

Background:

• Pancreatic surgery is frequently associated with significant postoperative complications.
• Predicting these adverse outcomes early remains a clinical challenge.
• Routine hepato-pancreato-biliary parameters, particularly liver enzymes, have not been extensively studied for their predictive value in this context.

Purpose of the Study:

• To investigate the correlation between postoperative liver enzymes and the incidence of complications following pancreatic resections.
• To identify early, clinically relevant routine parameters for predicting adverse outcomes in pancreatic surgery patients.

Main Methods:

• Retrospective analysis of prospectively documented data from 808 consecutive pancreatic resections at a tertiary care center (2003-2025).
• Analysis of laboratory values, including liver enzymes (AST, ALT), bilirubin, amylase, and lipase, during the first postoperative week.
• Descriptive and inferential statistical analyses were employed.

Main Results:

• Elevated aspartate aminotransferase (AST) correlated with postoperative hemorrhage, pulmonary insufficiency, MODS, and pneumonia.
• Elevated alanine aminotransferase (ALT) was associated with pulmonary insufficiency, pneumonia, and MODS.
• Elevated AST and ALT, especially with elevated pancreatic enzymes, show predictive potential for complications.

Conclusions:

• This study establishes a novel correlation between elevated postoperative AST and ALT levels and the development of postpancreatectomy complications.
• These liver enzymes, particularly when combined with elevated pancreatic enzymes, can serve as early indicators of patients at risk for severe outcomes.
• The findings suggest that monitoring AST and ALT may improve early identification and management of high-risk patients, potentially reducing failure-to-rescue rates.