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Hyperamylasemia after hepatic resection

T Tsuzuki1, S Shimizu, S Takahashi

  • 1Department of Surgery, Keio University School of Medicine, Tokyo, Japan.

The American Journal of Gastroenterology
|May 1, 1993
PubMed
Summary
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Hyperamylasemia, an elevation in amylase levels, is common after liver surgery. Different types of hyperamylasemia were observed, but their link to postoperative pancreatitis requires further investigation.

Area of Science:

  • Hepatobiliary Surgery
  • Clinical Chemistry
  • Gastroenterology

Background:

  • Hyperamylasemia is a recognized complication following hepatic resection.
  • The incidence and clinical significance of post-hepatectomy hyperamylasemia require further elucidation.

Purpose of the Study:

  • To investigate the incidence and patterns of hyperamylasemia after hepatic resection for liver cancer.
  • To explore potential correlations between hyperamylasemia and clinicopathological factors.
  • To discuss the implications of different hyperamylasemia types regarding postoperative pancreatitis.

Main Methods:

  • Retrospective analysis of 136 patients with hepatocellular carcinoma and 41 with metastatic liver cancer undergoing hepatic resection between July 1973 and April 1991.
  • Classification of hyperamylasemia into three types based on salivary and pancreatic amylase dominance.

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  • Correlation analysis with surgical extent, blood loss, hypoxemia, disseminated intravascular coagulation, liver cirrhosis, and hepatitis B virus infection.

    • Main Results:

    • Hyperamylasemia was observed in 42% of hepatocellular carcinoma patients and 32% of metastatic liver cancer patients.
    • No significant correlation was found between hyperamylasemia and the assessed clinicopathological factors.
    • Three patterns of hyperamylasemia were identified: salivary-dominant (Type I), pancreatic-dominant (Type II), and mixed (Type III).

    Conclusions:

    • Hyperamylasemia is a frequent occurrence after hepatic resection, irrespective of underlying liver disease or surgical details.
    • The clinical implications of pancreatic-type dominant hyperamylasemia (Type II and III) concerning postoperative pancreatitis warrant careful consideration.
    • Surgeons should maintain awareness of hyperamylasemia as a potential postoperative complication and manage patients accordingly based on amylase patterns.