Operations associated with postoperative pancreatitis:
(1) coronary artery bypass graft (CABG), cardiopulmonary bypass or other cardiac surgery
(2) pancreatic surgery
(3) biliary surgery
(4) surgery on other intra-abdominal organs
(5) orthopedic surgery
Risk factors for pancreatic injury in the perioperative period:
(1) trauma to the pancreas
(2) hypotension resulting in visceral ischemia (low cardiac output or post-pump syndrome)
(3) drug-induced injury
(4) gallstones
The diagnosis can be made by:
(1) abdominal pain
(2) elevation of serum amylase and lipase
(3) evidence of pancreatic inflammation on imaging studies
(4) exclusion of other diagnoses
The diagnosis may be missed if:
(1) The pancreatitis is mild or atypical.
(2) The patient is unconscious.
(3) The patient is sedated or on pain medications.
(4) The serum amylase and lipase are not measured after surgery.
(5) There is no preoperative serum amylase and lipase for comparison.
(6) The diagnosis is not suspected.
