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KMID : 1188520120080020055
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Korean Journal of Clinical Oncology
2012 Volume.8 No. 2 p.55 ~ p.61
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Analysis of Postgastrectomy Serum Amylase
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Jung Sung-Woo
Ahn Dae-Ho
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Abstract
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Purpose : To elucidate the mechanism of postgastrectomy hyperamylasemia, we analyzed serum amylase level after gastrectomy.
Materials and Methods : We retrospectively reviewed the prospectively collected data of serum amylase level of 497 patients who had undergone gastrectomy for gastric cancer from 2004 to 2010. Amylase level was measured at immediate postoperative period and on postoperative day 1. Amylase level was analyzed according to the operative procedures, such as the types of gastric resection, reconstruction methods, whether performing Kocher maneuver or not, and the extent of lymph node dissection.
Results : The serum amylase showed its peak level on postoperative day 1, and it returned to the plateau level by the postoperative day 3 in most patients. The proportion of patients with serum amylase more than 250 U/L on postoperative day 1 was analyzed based on the operative procedures. Lymph node dissection was engaged in higher level of serum amylase : D0, D1, D2: 6, 21, 21% respectively (P=0.022). Kocher maneuver didn’t have any effect on amylase level. Total gastrectomy with or without splenectomy (30%, 29% respectively) showed higher level than partial gastrectomy (17%) (P=0.004). Distal pancreatectomy showed significantly high serum amylase. The types of anastomosis exhibited the ratio difference of 18%, 17%, and 29% according to gastroduodenostomy, gastrojejunostomy or Roux-en-Y esophagojejunostomy (P=0.026).
Conclusion : Lymph node dissection, total gastrectomy with Roux-en-Y esophagojejunostomy, and pancreas resection exhibited higher serum amylase level on postoperative day 1 after gastrectomy.
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KEYWORD
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hyperamylasemia, gastrectomy, amylases
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