Hyperamylasemia after hepatic resection.

It has been noticed that hyperamylasemia occurs after hepatic resection. Between July 1973 and April 1991, hyperamylasemia was observed in 57 (42%) of 136 patients with hepatocellular carcinoma and 13 (32%) of 41 patients with metastatic liver cancer. The incidence was not correlated with extent of resection, blood loss, hypoxemia, disseminated intravascular coagulation, liver cirrhosis, or hepatitis B virus infection. There were three patterns: salivary-type dominant hyperamylasemia (type I), pancreatic-type dominant hyperamylasemia (type II), and a mixture of types I and II (type III). The point at issue is whether types II and III indicate postoperative pancreatitis. Although the pathogenesis remains unclear, surgeons should be alert to this complication and take reasonable measures with regard to the types of hyperamylasemia.