Vol 11, No 4 (2005)
Research paper
Published online: 2005-11-20
Pancreatic injury following elective abdominal aortic repair
Acta Angiologica 2005;11(4):204-211.
Abstract
Background. Open repair of abdominal aortic aneurysm (AAA) is still associated with substantial perioperative
mortality, which is in turn related to complications that are difficult to predict. The purpose of this
study was a biochemical, clinical and ultrasonographic analysis of pancreas in patients after elective repair
of AAA.
Material and methods. A group of 132 patients scheduled for the elective AAA repair was analyzed. Data regarding age, gender, medical history with a special emphasis on pancreatic disease, diabetes, ischemic heart disease, chronic obstructive pulmonary disease, chronic renal insufficiency, obesity (BMI > 30), cholelithiasis and alcoholism was taken and analyzed. According to the size of the aneurysms three groups were created: 4.5-5.5 cm; 5.6-7.0 cm and > 7.0 cm. The laboratory test were performed three times: preoperatively, on the 2nd and on the 5th postoperative day. Serum amylase, lipase, AspAT, AlAT, bilirubin and lactic acid were analyzed. Ultrasound scan was performed preoperatively and on the 5th postoperative day.
Results. In 20 patients statistically significant increase of serum level of amylase and lipase was found (p < 0.01). The gender of the patient did not have any significant influence on the development of pancreatic dysfunction. The pancreatic dysfunction occurred in eight patients younger than 70 years of age and in 12 older than 70 years of age and the difference was statistically significant (p < 0.05). The aneurysm greater than 7.0 cm in 11 patients was found. Both clinical and biochemical symptoms of acute pancreatitis were present in two patients (1.5%). The pancreatic injury was more frequent in patients with large AAA (> 7 cm). Conclusion. Pancreatic injury after elective AAA repair is related to the size of the aneurysm and probably caused by intraoperative iatrogenic trauma. Ischemia of the pancreas caused by blood loss may also play a role. Pancreatic dysfunction is more frequent in patients over 70 years of age.
Material and methods. A group of 132 patients scheduled for the elective AAA repair was analyzed. Data regarding age, gender, medical history with a special emphasis on pancreatic disease, diabetes, ischemic heart disease, chronic obstructive pulmonary disease, chronic renal insufficiency, obesity (BMI > 30), cholelithiasis and alcoholism was taken and analyzed. According to the size of the aneurysms three groups were created: 4.5-5.5 cm; 5.6-7.0 cm and > 7.0 cm. The laboratory test were performed three times: preoperatively, on the 2nd and on the 5th postoperative day. Serum amylase, lipase, AspAT, AlAT, bilirubin and lactic acid were analyzed. Ultrasound scan was performed preoperatively and on the 5th postoperative day.
Results. In 20 patients statistically significant increase of serum level of amylase and lipase was found (p < 0.01). The gender of the patient did not have any significant influence on the development of pancreatic dysfunction. The pancreatic dysfunction occurred in eight patients younger than 70 years of age and in 12 older than 70 years of age and the difference was statistically significant (p < 0.05). The aneurysm greater than 7.0 cm in 11 patients was found. Both clinical and biochemical symptoms of acute pancreatitis were present in two patients (1.5%). The pancreatic injury was more frequent in patients with large AAA (> 7 cm). Conclusion. Pancreatic injury after elective AAA repair is related to the size of the aneurysm and probably caused by intraoperative iatrogenic trauma. Ischemia of the pancreas caused by blood loss may also play a role. Pancreatic dysfunction is more frequent in patients over 70 years of age.
Keywords: abdominal aortic aneurysmpancreaspancreatic injuryrepair of aortic aneurysms