SERUM AMYLASE ELEVATION FOLLOWING HEPATIC RESECTION IN PATIENTS WITH CHRONIC LIVER-DISEASE

BACKGROUND: Factors liable to cause hyperamylasemia after hepatectomy were studied retrospectively in 140 patients with chronic liver diseas e, METHODS: The Pringle maneuver was performed in 113 patients (Pringl e group), the hemihepatic vascular occlusion technique in 21 (hemihepa tic group), and no vascular occlusion in 6 (no-occlusion group). RESUL TS: In the Pringle group, postoperative serum amylase levels were elev ated significantly in comparison with the preoperative levels, but wer e not elevated in hemihepatic and no-occlusion groups. In the Pringle group, there were 4 patients whose postoperative serum amylase levels exceeded 3.5 times the upper limit of the normal range together with s erum pancreatic isoamylase or lipase elevation or both, When compared with the other 109 patients, these 4 patients had a significantly long er vascular occlusion time (51 +/- 3 minutes versus 94 +/- 8 minutes, P <0.005). One of them developed pancreatitis and died from hepatic fa ilure. CONCLUSION: Prolongation of portal congestion carries a potenti al risk of serum amylase elevation and pancreatitis after hepatectomy in patients with underlying liver disease.