Tocchi A, Mazzoni G, Liotta G, Lepre L, Costa G, Miccini M
, Istituto di I Clinica Chirurgica, Università degli Studi La Sapienza, Roma.
G Chir. 1998 Jun-Jul;19(6-7):262-4.
Preoperative and postoperative values of amylase were assessed in patients submitted to hepatic resections for primary or secondary liver tumours. Among these 40 had underlying liver cirrhosis and 18 normal liver. Preoperative serum amylase levels were increased in patients with cirrhosis. Postoperative amylase levels were found to be overlapping to preoperative one both in patients with normal and cirrhotic liver when no Pringle's manoeuvre was used in the course of surgery. A significant postoperative increase in serum amylase levels was detected in the group of patients where liver resection was carried out under Pringle's manoeuvre. Two patients of the cirrhotic group developed mild pancreatitis. It is suggested that portal congestion relates morphological changes of pancreas and hyperamylasemia and that Pringle's manoeuvre, if prolonged, carries a potential risk of pancreatitis especially in patients with underlying liver cirrhosis.