Publications

Authors:

Bannone, Elisa; Marchegiani, Giovanni; Balduzzi, Alberto; Procida, Giuseppa; Vacca, Pier Giuseppe; Salvia, Roberto; Bassi, Claudio

Title:

Early and Sustained Elevation in Serum Pancreatic Amylase Activity: A Novel Predictor of Morbidity After Pancreatic Surgery

Year:

2023

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

Annals of Surgery

ISSN of journal:

0003-4932

N° Volume:

277

Number or Folder:

1

Page numbers:

N/A-N/A

Keyword:

postoperative hyperamylasemia; postpancreatectomy acute pancreatitis; serum amylase trend

Short description of contents:

Objective:To characterize early postoperative serum pancreatic amylase (spAMY) trends after pancreatic resections. Summary Background Data:A postoperative spAMY elevation is a common finding but uncertainties remain about its meaning and prognostic implications. Methods:Analysis of patients who consecutively underwent pancreatectomy from 2016 to 2019. spAMY activity was assessed from postoperative day (POD) 0 to 3. Different patterns of spAMY have been identified based on the spAMY standard range (10-52 U/l). Results:Three patterns were identified: (#1) spAMY values always < the lower limit of normal/within the reference range /a single increase in spAMY > upper limit of normal at any POD; (#2) Sustained increase in spAMY activity on POD 0 + 1; (#3) Sustained increase in spAMY activity including POD 1 + 2. Shifting through spAMY patterns was associated with increase morbidity (21% in #1 to 68% in #3 at POD 7; log rank < 0.001). Almost all severe complications (at least Clavien-Dindo >= 3) occurred in patients with pattern #3 (15% vs 3% vs 5% in #1 and #2 at POD 7, P = 0.006), without difference considering >3-times or >the spAMY normal limit (P = 0.85). POPF (9% in #1 vs 48% in #3, P < 0.001) progressively increased across patterns. Pre-operative diabetes (OR 0.19), neoadjuvant therapy (OR 0.22), pancreatic texture (OR 8.8), duct size (OR 0.78), and final histology (OR 2.2) were independent predictors of pattern #3. Conclusions:A sustained increase in spAMY activity including POD 1 + 2 (#3) represents an early postoperative predictor of overall and severe early morbidity. An early and dynamic evaluation of spAMY could crucially impact the subsequent clinical course with relevant prognostic implications.

Product ID:

135625

Handle IRIS:

11562/1108947

Last Modified:

October 27, 2024

Bibliographic citation:

Bannone, Elisa; Marchegiani, Giovanni; Balduzzi, Alberto; Procida, Giuseppa; Vacca, Pier Giuseppe; Salvia, Roberto; Bassi, Claudio, Early and Sustained Elevation in Serum Pancreatic Amylase Activity: A Novel Predictor of Morbidity After Pancreatic Surgery «Annals of Surgery» , vol. 277 , n. 1 , 2023 , pp. N/A-N/A

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