Pattern of pancreatic amylase enzyme change in the early postoperative period as a marker of evolution and development of postoperative pancreatitis

BACKGROUND: Postoperative pancreatitis is a severe complication in the postoperative period, which threatens not only the favorable outcome of the surgery but also the patient’s life. Postoperative pancreatitis proceeds and develops with a mechanism very similar and close to that of acute pancreatitis. However, there are many peculiarities in its etiology and mode of course of development that make it interesting and give it individual features. A correlation was found in a search for a method to determine whether rising serum levels of pancreatic amylase enzyme are a sign of developing pancreatitis or just postoperative hyperamylasemia. This correlation does not connect amylase enzyme levels directly with the development and severity of postoperative pancreatitis. The pattern of change and development of amylase enzyme levels in the early postoperative period creates specific and different models directly connected with the development of postoperative pancreatitis and its complications.METHODS: For the period from 2018 to 2023, 415 patients were diagnosed who developed postoperative pancreatitis after surgical intervention. These patients were examined by gender, age, preoperative laboratory parameters, type and extent of surgical intervention, postoperative laboratory parameters, postoperative instrumental and imaging studies, and type of postoperative complications following the development of pancreatitis. Patients were followed prospectively and retrospectively concerning demographics, history, status, laboratory test data, type of surgical intervention performed, and postoperative hospital stay.RESULTS: Different patterns of change in the enzyme values over time were constructed concerning the amylase values in the postoperative period as evidenced by the first 4 blood samples taken every 12 hours. A non-hierarchical cluster analysis of the change in amylase values over time was used. Thus, grouped according to the pattern of change over time, seven statistically significant groups showing different patterns of change in amylase values were found to form. After the distribution of amylase change patterns into seven cluster groups, the predominant development of a certain type of complications under a certain amylase change pattern was identified.CONCLUSIONS: Utilizing this method, a prognostic prediction can be applied and the development of postoperative pancreatitis and its severe complications can be prevented.