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

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To characterize early postoperative serum pancreatic amylase (spAMY) trends after pancreatic resections.A postoperative spAMY elevation is a common finding but uncertainties remain about its meaning and prognostic implications.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).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 3-times or >the spAMY normal limit (p = 0.85). POPF (9% in #1 vs. 48% in #3, p

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