Objective: To investigate the prognostic factors of
hyperamylasemia following
pancreaticoduodenectomy (PD) . Methods: Clinical data of 359 patients were collected prospectively who underwent PD by the same group at Changhai Hospital of Navy Medical University from January 2017 to June 2018.There were 212 males and 147 females.The median age was 63 years old (range: 23 to 82 years old) .According to whether the patient's serum
amylase was greater than 120 U/L at 0 or 1 day after surgery,the patients were divided into
hyperamylasemia group and non-
hyperamylasemia group. Univariate analysis and multivariate analysis were used to find out the prognostic factors of
hyperamylasemia after PD. Results: Of the 359 patients, 238 cases (66.3%) developed
hyperamylasemia.The incidence rate of clinically related
pancreatic fistula (15.1% vs.2.5%, P<0.01) , grade B/C post
pancreatectomy hemorrhage (8.8% vs. 2.5%, P<0.01) , and
surgical site infection (9.2% vs. 3.3%, P=0.04) was significantly higher in the
hyperamylasemia group.The severity of complications (CD grade≥Ⅲ: 11.3% vs.4.1%, P=0.023) and postoperative
hospital stay (11 days vs. 9 days, P=0.001) were higher in the
hyperamylasemia group.In the multivariate analysis, the main pancreatic duct diameter (MPD) ≤3 mm (OR=4.469, 95% CI: 2.563-7.793, P<0.01) , pathological type of
disease (pancreatic cancer or
pancreatitis) (OR=0.230, 95% CI: 0.122-0.436, P<0.01) and soft texture of pancreas (OR=3.297, 95%CI: 1.930-5.635, P<0.01) were independent prognostic factors for
hyperamylasemia. Conclusions: Post-PD
hyperamylasemia increased the incidence and severity of postoperative complications after PD.MPD≤3 mm, soft texture of pancreas and pathological type of disease were independent prognostic factors of
hyperamylasemia.