Postoperative pancreatitis

Our experience with 52 patients who had postoperative pancreatitis develop during a nine year period was reviewed to characterize this group, to determine the incidence of complications and to identify variables predictive of complications. Biliary tract procedures (n=10), colectomy (n=9) and intestinal resection (n=9) were the most frequently performed operations preceding pancreatitis. Thirty of the procedures were near the pancreas. Pancreatitis was detected within seven days of the operation in 26 of the patients. Sixteen patients had complications related to the pancreas, 12 had other nonlethal complications and nine died. Fourteen patients had severe pancreatitis (≥3 Ranson's criteria) and were more likely to have a complicated course (p<0.05). Complications related to the pancreas included pancreatic pseudocyst (n=9), abscess (n=4), fistula (n=2) and arterial hemorrhage (n=1). Age, operation performed, serum amylase level and frequency of hypotension, renal failure and other complications were similar in patients with and without complications related to the pancreas. A high index of suspicion must remain throughout the postoperative period to recognize inflammation of the pancreas and its complications so that prompt diagnosis and management can be undertaken.