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Hyperamylasemia associated with lymphadenectomy in patients surgically treated for gastric cancer.

The influence of standard lymphadenectomy on the occurrence of damage to the pancreas was evaluated in 28 patients with gastric cancer, by analysing related serum and urine enzyme activities, pre- and postoperatively. Enzymatic evidence for pancreatic damage was related to the surgical procedure performed. Postoperatively, the patients treated by R2 gastrectomy had significantly increased levels of P-type amylase in the serum compared with findings in patients treated by R1 gastrectomy or bypass procedures. Conversely, the S-type amylase in both groups remained within normal limits during the study period. Pancreatic secretary trypsin inhibitor (PSTI) and phospholipase A2 (PLA2) proved to be less sensitive to pancreas damage caused by lymphadenectomy. The R2 patients with P-type hyperamylasemia had no major postoperative complications. Thus, while the standard R2 gastrectomy may well be a relevant factor associated with the occurrence of transient P-type hyperamylasemia, there seems to be no relation to major postoperative complications such as pancreatitis.