Hyperamylasaemia after laparoscopic gastrointestinal surgery

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Objective To investigate the clinical significance and risk factors of the hyperamylasemia after laparoscopic gastrointestinal operation.Methods In this study 200 patients undergoing laparoscopic gastrointestinal surgery between March 2011 and July 2012 were divided into two groups based on serum amylase level.The postoperative complications were observed.Hyperamlasemia was defined as more than 110 IU/L.Factors related with hyperamylasemia were selected and t-test,chi-square test were used for univariate analysis.Statistically significant variables was used for multivariate logistic regression analysis.Results Of 200 patients,94 cases (47％) had postoperative hyperamylasemia including 59 cases(56％) of gastrectomy and 35 cases (37％) of colorectal surgery.22 cases (11％) developed post-operative complications,there were 15 cases (16％) from hyperamylasemia group including one case of acute pancreatitis,and 7 patients (7％) from euamylasemia group (x2 =4.452,P =0.035).Univariate analysis showed that BMI (body mass index) ＞ 25 kg/m2,upper abdominal surgery,surgical approach,patient position,duration of operation,resection of pancreas capsule,CO2 pneumoperitoneum pressure and pneumoperitoneum duration were significant factors (P ＜ 0.1).Logistic regression analysis revealed that the length of operation,upper abdominal surgery,CO2 pneumoperitoneum pressure and duration of pneumoperitoneum were related to postoperative hyperamylasemia (P ＜ 0.05).Conclusions There was high incidence of postoperative hyperamlasemia in laparascopic procedures leading to increased risk of postoperative complications,such as infection.Upper abdominal surgery,CO2 pneumoperitoneum pressure,longer operation and pneumoperitoneum time are independent risk factors related with postoperative hyperamylasemia after laparoscopic gastrointestinal surgery. Key words: Hyperamylasemia; Laparoscopes; Pneumoperitoneum, artificial; Postoperative complications