Study on postoperative hyperamylasemia
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概要
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Amylase isoenzymes were identified by use of agar or cellogel electrophoresis and quantified by densitometry of the zymogram in patient's sera showing hyperamylasemia following various surgical operations.In 5 out of 18 cases with radical mastectomy or orthopedic operations and in 12 out of 34 cases with operations by spinal anesthesia, hyperamylasemia was found. The increased activity of serum amylase was salivary origin in all cases above mentioned. Out of 87 cases with operated cholelithiasis, 18 cases were found to have hyperamylasemia. In 14 cases with postoperative hyperamylasemia following simple cholecystectomy, all of them were owing to amylase of salivary origin. However, hyperamylasemia owing to increased amylase of pancreatic origin was found in 4 cases following cholecystectomy plus choledochotomy or papilloplasty. In 24 out of 46 cases with gastrectomy, postoperative hyperamylasemia was seen. Hyperamylasemia due to increased activity of amylase of pancreatic origin was seen in 17 cases, and all of them had gastrectomy and lymphnode dissection (R2).In fasting sera of normal subjects, the ratio of salivary amylase to pancreatic amylase was increased when compared with that of control subjects. Furthermore, it was experimentally demonstrated that amylase activity of salivary gland of starved rats was markedly increased, although that of pancreas was decreased.From these findings, it is concluded that most of postoperative hyperamylasemia following various operations which do not give any direct damage on pancreas is owing to increased amylase activity of salivary origin, and this phenomenon might be induced by starvation.
- 財団法人 日本消化器病学会の論文