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Postpancreatectomy acute pancreatitis: Fact? Fiction? Functional definition and future

Published:November 23, 2020DOI:https://doi.org/10.1016/j.surg.2020.10.023
      This special series features four papers addressing the concept of postpancreatectomy acute pancreatitis. Pancreatic surgeons have long recognized that some percentage of pancreatectomy patients manifest increases in circulating pancreatic enzyme (amylase, lipase) activity in the immediate postoperative period. The clinical relevance of these increases in serum enzyme activity (which for the sake of clarity I will refer to as “postoperative serum hyperamylasemia” or POSH) is a bit more controversial in the discipline. Specifically, the questions of whether POSH or postoperative acute pancreatitis (POAP) causes clinical morbidity remain incompletely defined. In personal anecdotal experience, I have seen pancreatic edema of the pancreatic remnant tail develop intraoperatively during pancreatic head resection, and, in 1 extreme case, cared for a patient who developed necrotizing pancreatitis as a consequence of pancreatoduodenectomy.
      • Simianu V.V.
      • Ramsey M.P.
      • Sherman S.
      • Zyromski N.J.
      Necrotizing pancreatitis caused by pancreatoduodenectomy.
      I have no doubt that this entity exists; the current reports further our knowledge of as well as highlight knowledge gaps surrounding this condition.
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