Serum lipase level at postoperative day 1 is a more useful biomarker in objective evaluation of pancreatic exocrine function: a preliminary study

Background: The aim of this preliminary study was to evaluate if serum lipase level at postoperative day (POD) 1 (Lipase1) would be a useful biomarker in objective evaluation of pancreatic texture. Patients and methods: Between January 2016 and December 2017, 36 patients who underwent pancreaticoduodenectomy (PD) were analyzed. Normal value of serum lipase level was defined as ranging from 8-49 U/L. Pancreatic texture was defined by the operating surgeon as soft or hard based on the palpation during surgery. Clinically relevant pancreatic fistula (PF) was defined as Grade B/C PF according to the International Study Group of Pancreatic Surgery 2016. Results: Median Lipase1 was 111U/L (0-727U/L) in this population. Of 36 patients, Lipase1 was elevated beyond normal range in 23 patients (Group 1), in whom median Lipase1 was 255 U/L (50–727 U/L). Meanwhile, Lipase1 was below normal range in 13 patients (Group 2), in whom median Lipase1 was 2 U/L (0–23 U/L). In this study population, 19 patients had soft pancreatic texture, and all of them were included in Group 1. Of 17 patients having hard pancreatic texture, 13 patients were included in Group 2, while Lipase1 was elevated in 4 patients with median value of 76 U/L (50-199 U/L). Clinically relevant PF occurred in 9 patients, consisting of 8 patients in Group 1 and one patient in Group 2. Among 9 patients, 8 patients had soft pancreatic texture and all of them were included in Group 1. Conclusions: Lipase1 may be a more useful biomarker to objectively evaluate of pancreatic exocrine function.