Willems D, Hooghe L, Kinnaert P, Van Geertruyden J
Clinique chirurgicale et Laboratoire de Biologie Clinique, Hôpital Brugmann, Université Libre de Bruxelles, Belgique.
Gastroenterol Clin Biol. 1988 Apr;12(4):347-53.
Recent studies have cast doubt on the concept of causative association between parathyroidectomy for primary hyperparathyroidism and postoperative pancreatitis. The present study indicated that the relationship was real and that the development of acute pancreatitis after parathyroid surgery was not purely incidental. Acute pancreatitis was observed postoperatively in 3 p. 100 of cases after parathyroidectomy (6/196 cases), in 37 p. 100 after pancreatic surgery (19/51 cases), but never after thyroidectomy (100 cases) or other extra-abdominal operations (100 cases). During the first five postoperative days, the incidence of hyperamylasemia was 16 p. 100 after parathyroidectomy, 47 p. 100 after pancreatic surgery, 3 p. 100 after thyroidectomy, 2 p. 100 after other extra-abdominal operations. During the same period, the frequency of hyperlipasemia was similar: 20 p. 100 after parathyroidectomy, 54 p. 100 after pancreatic surgery, 1 p. 100 after thyroidectomy, 0 p. 100 after other extra-abdominal operations. In all cases with hyperamylasemia after parathyroidectomy, the pancreatic fractions of amylase isoenzymes were abnormally elevated.
近期的研究对原发性甲状旁腺功能亢进症甲状旁腺切除与术后胰腺炎之间的因果关联概念提出了质疑。本研究表明这种关系是真实存在的，甲状旁腺手术后急性胰腺炎的发生并非纯属偶然。甲状旁腺切除术后，每100例中有3例（6/196例）术后观察到急性胰腺炎；胰腺手术后，每100例中有37例（19/51例）出现；但甲状腺切除术后（100例）或其他腹部外手术（100例）后从未发生。术后前五天，甲状旁腺切除术后高淀粉酶血症的发生率为每100例中有16例，胰腺手术后为每100例中有47例，甲状腺切除术后为每100例中有3例，其他腹部外手术后为每100例中有2例。同一时期，高脂血症的发生率相似：甲状旁腺切除术后为每100例中有20例，胰腺手术后为每100例中有54例，甲状腺切除术后为每100例中有1例，其他腹部外手术后为每100例中有0例。在所有甲状旁腺切除术后出现高淀粉酶血症的病例中，淀粉酶同工酶的胰腺部分均异常升高。
