Immunological Pathways in the Development of Postoperative Hyperamylasemia and Postoperative Pancreatitis – Preliminary Results

Abstract

Postoperative pancreatitis complications can be separated into two main groups based on literature reviews and clinical and experimental trials. Some authors suggest that postoperative pancreatitis is a severe complication that should be treated conservatively and operatively if needed. Other authors defend an opposite opinion that only postoperative hyperamylasemia exists, which is a transitory condition with no risk of complications. At “Alexandrovska” University Hospital for Active Treatment, Clinic of General and Liver-Pancreatic Surgery, a cohort of patients with increased amylase concentrations in the postoperative period between January 2017 and December 2018 were studied and followed with immunological and biochemical tests for interleukin (IL)-6. Regardless of the type of surgery to which they were subjected, all patients who presented with an elevated amylase concentration in the postoperative period were selected. The working hypotheses were the following: i) IL-6 is directly relevant in the development of postoperative pancreatitis; ii) the concentration of IL-6 is a prognostic factor in the early postoperative period and marks the boundary at which patients will develop postoperative pancreatitis and its various clinical manifestations; and iii) the postoperative period is accompanied by transient postoperative hyperamylasemia and absence of complications. To test these hypotheses, the values of IL-6 were statistically analyzed using SPSS v23 software. The results show that, with a 95% confidence interval (CI), a statistically significant difference is found in the concentration of IL-6 in patients who developed postoperative pancreatitis versus those with transient hyperamylasemia. The present study shows a direct link between the immunological marker, IL-6, and the course of both postoperative pancreatitis and transient hyperamylasemia, making this marker valuable in elucidating the differences in the development of postoperative pancreatitis and transient hyperamylasemia in the early postoperative period. Thus, IL-6 can be used to reach the correct diagnosis and decide effective treatment.