[Clinical characteristics of pancreatitis after cardiovascular surgery]

Increases in pancreatic enzyme levels after cardiovascular surgery were studied, and their clinical characteristics evaluated. The subjects were 128 patients who had undergone cardiovascular surgery (65 patients after valve replacement, 32 after coronary bypass surgery and 31 after aortic artificial graft replacement). The pancreatic enzyme (serum amylase and lypase) levels were monitored serially before and after operation, and amylase fractions were measured at their peaks. The relationships of the peak lypase level with underlying cardiac diseases, background factors, factors related to surgery, factors related to the extracorporeal circulation, presence or absence of symptoms, and treatments were examined. The amylase level exhibited biphasic changes consisting of a peak in which salivary glands amylase (S type) was dominant and a peak in which pancreatic amylase (P type) was dominant. The second peak coincided with the peak lypase and occurred mostly 3 to 10 days after operation. The peak lypase level exceeded the normal range in 78% of all the patients. It exceeded 564 U/l, 4 times the normal value in 28% of the patients, many of whom were symptomatic. So, we recommended that these cases should be treated as "postoperative pancreatitis". A high peak lypase level showed a significant correlation with the history of gallbladder and pancreatic diseases and diabetes mellitus among the background factors and emergency operation and the use of IABP among the surgery-related factors.(ABSTRACT TRUNCATED AT 250 WORDS)