The Causes and Clinical Significance of Hyperamylasemia Following Colorectal Surgery

ABSTRACT

PURPOSE: Postoperative hyperamylasemia and pancreatitis may sometimes follow abdominal surgery but the significance and cause of hyperamylasemia after colorectal surgery were not studied enoughly. Our study was designed to identify the incidence of hyperamylasemia after colorectal surgery, to investigate the effect of hyperamylasemia on postoperative hospital course, and to clarify the causes such as extent of colorectal resection or intraoperative events. METHODS: The serum amylase was determined in post operative first day in random sampled 72 patient among whom underwent elective colorectal resection from March 2000 to July 2001. If a hyperamylasemia was evident, repeated check the level till it returned to within normal range. Other factors that seemed to affect serum amylase such as traction of pancreas during operative manupulation, intraoperative hypotensive episode or infused drug and volume expanders etc. were reviewed and analysed. RESULTS: Hyperamylasemia occurred in 25 patients (34.7%) after colorectal surgery. Serum amylse level returned to normal in all but nine patients (12.4%) by third postoperative day, two patients (2.8%) by the fifth postoperative day. Pancreas manupulation and intraoperative use of volume expander, amylopectin were found to be significantly associated with postoperative hyperamylasemia by 2-test and pearson correlation analysis. The developement of hyperamylasemia did not adversely influence the postoperative hospital course. CONCLUSIONS: Twenty-five (34.7%) in seventy-two patients who underwent colorectal surgery developed hyperamylasemia after operation. The incidence was significantly high in a group who underwent surgical procedure with more pancreas manupulation and infused hydroxyethyl starch (amylopectin) containing volume expander. The development of postoperative hyperamylasemia did not seem to influence adversely the postoperative hospital course in this study.