Skip to main content Skip to main navigation menu Skip to site footer

Unsolved mystery, the etiology of acute pancreatitis after liver resection: a case report and literature review

  • Mochamad Syahroni Fardiansyah ,
  • Denny Septarendra ,
  • Rena Normasari ,

Abstract

Link of Video Abstract: https://youtu.be/WQnJQwwYcHc

Introduction:
After liver resection, pancreatitis is a well-known yet uncommon consequence. The actual cause is unclear, and the postoperative condition may mask the clinical symptoms. When a patient unexpectedly worsens after surgery, postoperative pancreatitis should always be taken into consideration due to its high fatality risk. After liver resection, we present our patient with acute pancreatitis. The paper was written using certain hypotheses. First, the surgeon should be aware of the possibility of pancreatitis following liver surgery, which is not included in the literature as a side effect of liver surgery. The second step is to increase our knowledge and develop measures to reduce the risk of acute pancreatitis following liver surgery.

Case Description: We present here a case of acute pancreatitis following liver resection surgery from our institution, and we strongly suspect that the results of our postoperative white bile leak test contributed to this. According to the literature analysis, this test is risk-free and won't have a materially detrimental impact on the patient. Keep in mind the white test rule, which suggested things like focus and spooling following the test.

Conclusion: The white test is effective for identifying bile leakage following liver resection, however, we do not advise frequent use of this test since there is a chance that it can trigger acute pancreatitis, which can have a substantial negative impact on the patient's morbidity or death. The precise process is still a mystery and will require further experimental research.

References

  1. Sathasivam S, Ritchie A, Brooks AJ, Morris DL. Acute pancreatitis following liver resection: report of three fatal cases and a review of the literature. ANZ J Surg. 2004;74(8):643-5.
  2. Chopinet S, Bollon E, Hak JF, Reydellet L, Blasco V, Tradi F, et al. The white test for intraoperative screening of bile leakage: a potential trigger factor for acute pancreatitis after liver resection—a case series. BMC Surg. 2021;21:356.
  3. Mergener K, Baillie J. Fortnightly review: Acute pancreatitis. BMJ. 1998;316:44-8.
  4. Miyagawa S, Makuuchi M, Kawasaki S, Kakazu T, Hayashi K, Kasai H. Serum amylase elevation following hepatic resection in patients with chronic liver disease. Am J Surg. 1996;171(2):235-8.
  5. Guillaud A, Pery C, Campillo B, Lourdais A, Laurent S, Boudjema K. Incidence and predictive factors of clinically relevant bile leakage in the modern era of liver resections. HPB. 2013;15(3):224-9.
  6. Hayashi K, Abe Y, Shinoda M, Kitago M, Yagi H, Oshima G, et al. Clinical impact of intraoperative bile leakage during laparoscopic liver resection. Surg Endosc. 2021;35(8):4134-42.
  7. Wagdi HH, Khalil A, Saber HS, Elden KMG. White test versus conventional saline test in detecting intra-operative bile leakage in liver resection. QJM An Int J Med. 2021;114(Supplement 1):i133.
  8. Reber HA. Acute pancreatitis--another piece of the puzzle? N Engl J Med. 1991;325(6):423-5.
  9. Jarnagin WR. Blumgart’s Surgery of the Liver, Pancreas and Biliary Tract: Volume 1. 6th ed. Elsevier; 2016.
  10. Forsmark CE. Pancreatitis. In: Goldman L, Schafer AI, eds. Cecil Medicine 25th Edition. Saunders; 2016:959-63.
  11. Hruban R, Iacobuzio-Donahue C. The Pancreas. In: Kumar V, Abbas A, Aster JC, eds. Robbins & Cotran Pathologic Basis of Disease 10th Edition. Saunders; 2020:884-8.
  12. DeOliveira LC, Rezende PB, Ferreira AL, de Freitas AA, de Carvalho AM, Guedes CA, et al. Concurrent acute hepatitis and pancreatitis associated with hepatitis B virus: case report. Pancreas. 1998;16(4):559-61.
  13. Yoshimura M, Sakurai I, Shimoda T, Abe K, Okano T, Shikata T. Detection of HBsAg in the pancreas. Acta Pathol Jpn. 1981;31(4):711-7.
  14. Tsui CY, Burch GE, Harb JM. Pancreatitis in mice infected with coxsackievirus B1. Arch Pathol. 1972;93(5):379-89.
  15. Bolado F, Tarifa A, Zazpe C, Urman JM, Herrera J, Vila JJ. Acute recurrent pancreatitis secondary to hepatocellular carcinoma invading the biliary tree. Pancreatology. 2015;15(2):191-3.
  16. Martínez E, Milinkovic A, Lazzari E de, Ravasi G, Blanco JL, Larrousse M, et al. Pancreatic toxic effects associated with co-administration of didanosine and tenofovir in HIV-infected adults. Lancet. 2004;364(9428):65-7.
  17. López-Benítez R, Radeleff BA, Barragán-Campos HM, Noeldge G, Grenacher L, Richter GM, et al. Acute pancreatitis after embolization of liver tumors: frequency and associated risk factors. Pancreatology. 2007;7(1):53-62.
  18. Stefanini GF, Amorati P, Biselli M, Mucci F, Celi A, Arienti V, et al. Efficacy of transarterial targeted treatments on survival of patients with hepatocellular carcinoma. An Italian experience. Cancer1. 1995;75(10):2427-34.
  19. Komekado H, Kokuryu H, Kimura T, Maruo T, Kita R, Osaki Y, et al. Two cases of acute necrotizing pancreatitis complicating after transcatheter arterial embolization for hepatocellular carcinoma. J Gatroenterology. 2005;40(1):107-8.
  20. Takayama T, Makuuchi M, Inoue K, Sakamoto Y, Kubota K, Harihara Y. Selective and unselective clamping in cirrhotic liver. Hepatogastroenterology. 1998;45(20):376-380.
  21. Sakamoto Y, Makuuchi M, Takayama T, Minagawa M, Kita Y. Pringle’s maneuver lasting 322 min. Hepatogastroenterology. 1999;46(25):457-8.
  22. Ijichi M, Takayama T, Toyoda H, Sano K, Kubota K, Makuuchi M. Randomized trial of the usefulness of a bile leakage test during hepatic resection. Arch Surg. 2000;135(12):1395-400.
  23. Linke R, Ulrich F, Bechstein WO, Schnitzbauer AA. The White-test helps to reduce biliary leakage in liver resection: a systematic review and meta-analysis. Ann Hepatol. 2015;14(2):161-7.
  24. Nadalin S, Li J, Lang H, Sotiropoulos GC, Schaffer R, Radtke A, et al. The White test: a new dye test for intraoperative detection of bile leakage during major liver resection. Arch Surg. 2008;143(4):402-404.

How to Cite

Fardiansyah, M. S. ., Septarendra, D. ., & Normasari, R. . (2023). Unsolved mystery, the etiology of acute pancreatitis after liver resection: a case report and literature review. Bali Medical Journal, 12(3), 2907–2911. https://doi.org/10.15562/bmj.v12i3.4759

HTML
0

Total
0

Share

Search Panel

Mochamad Syahroni Fardiansyah
Google Scholar
Pubmed
BMJ Journal


Denny Septarendra
Google Scholar
Pubmed
BMJ Journal


Rena Normasari
Google Scholar
Pubmed
BMJ Journal