2020
DOI: 10.1016/j.hpb.2020.03.010
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Implications of increased serum amylase after pancreaticoduodenectomy: toward a better definition of clinically relevant postoperative acute pancreatitis

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Cited by 40 publications
(68 citation statements)
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“…[27][28][29][30][31] When mentioned, the Modified CT Severity Index 53 for AP was the most frequently reported method. 14,15,31 Moreover, there was no consensus on the appropriate timing of axial imaging, which differed between studies. Thus, the ability to see evidence of pancreatic inflammation on CTs varied tremendously.…”
Section: Resultsmentioning
confidence: 99%
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“…[27][28][29][30][31] When mentioned, the Modified CT Severity Index 53 for AP was the most frequently reported method. 14,15,31 Moreover, there was no consensus on the appropriate timing of axial imaging, which differed between studies. Thus, the ability to see evidence of pancreatic inflammation on CTs varied tremendously.…”
Section: Resultsmentioning
confidence: 99%
“…The pathologic findings indicative of PPAP included in such cases acute necrotizing pancreatitis in 41% to 57% of surgical specimens of completion pancreatectomies for grade-C POPF. 11,37 The Clinical Evidence Most series evaluating postoperative hyperamylasemia (POH) and PPAP showed an association of these conditions with increases in major postoperative morbidity, 15,17,18,41 and some series have documented PPAP associated with a greater perioperative mortality. 18,31 Most studies analyzing biochemical and radiologic findings of PPAP focused on its correlation with POPF, 6,10,13 -18,54 and many have identified PPAP as an independent predictor of POPF.…”
Section: The Pathologic Evidencementioning
confidence: 99%
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“…The threshold for plasma enzymes of revised Atlanta criteria 10 has also been used in the recent literature, as some studies have questioned Connor’s definition for including many patients without clinical signs of pancreatitis, thereby losing specificity 4 , 11 . However, most have primarily focused on POAP, while CR-POAP, potentially with higher specificity, has been less thoroughly investigated 12 .…”
Section: Introductionmentioning
confidence: 99%
“…Kühlbrey et al suggested that systemic hyperamylasemia detected on postoperative day 1 after pancreas surgery may be a good predictor for future development of clinically relevant POPFs 29 . Other studies also noted that an increase in serum amylase or lipase was possible markers for postoperative acute pancreatitis and suggested a clinical relationship between postoperative acute pancreatitis and POPF 30‐32 . Postoperative serum amylase and lipase were elevated in all 4 DAP cases, as is typical following pancreas transplantation, but with a downward trend in all cases.…”
Section: Discussionmentioning
confidence: 98%