HYPERAMYLASEMIA AFTER HEPATIC RESECTION

It has been noticed that hyperamylasemia occurs after hepatic resectio n. Between July 1973 and April 1991, hyperamylasemia was observed in 5 7 (42%) of 136 patients with hepatocellular carcinoma and 13 (32%) of 41 patients with metastatic liver cancer. The incidence was not correl ated with extent of resection, blood loss, hypoxemia, disseminated int ravascular coagulation, liver cirrhosis, or hepatitis B virus infectio n. There were three patterns: salivary-type dominant hyperamylasemia ( type I), pancreatic-type dominant hyperamylasemia (type II), and a mix ture of types I and II (type III). The point at issue is whether types II and III indicate postoperative pancreatitis. Although the pathogen esis remains unclear, surgeons should be alert to this complication an d take reasonable measures with regard to the types of hyperamylasemia .