Hyperamylasemia after post-chemotherapy retroperitoneal lymph node dissection for testis cancer.

Abstract

Postoperative hyperamylasemia was evaluated in patients undergoing post-chemotherapy retroperitoneal lymph node dissection for testis cancer. Serum levels of amylase, lipase and bilirubin were evaluated prospectively in the immediate postoperative period in 39 consecutive patients who underwent post-chemotherapy retroperitoneal lymph node dissection. Hyperamylasemia was found in 16 patients (41%), hyperlipasemia in 17 (43%) and hyperbilirubinemia in 9 (23%). Peak elevations were observed at 24 hours postoperatively and most returned to normal at 1 week. Elevation of these parameters was significantly associated with length and difficulty of the procedure. No patient demonstrated clinical acute pancreatitis. Extended retraction of the pancreas during post-chemotherapy retroperitoneal lymph node dissection may cause a minor reversible injury to the pancreas expressed as hyperamylasemia, hyperlipasemia and, rarely, jaundice. These findings are important to consider in the differential diagnosis of hyperamylasemia following post-chemotherapy retroperitoneal lymph node dissection.