Increased Serum Pancreatic Enzymes after Bilateral Laparoscopic Nephroureterectomy for Transitional Cell Carcinoma of Renal Pelvis

腎盂移形細胞癌病患接受兩側腹腔鏡腎臟輸尿管切除手術後血清胰臟酵素劇烈增高

王賢祥(Shian-Shiang Wang) ； 歐宴泉(Yen-Chuan Ou) ； 程千里(Chen-Li Cheng) ； 楊啓瑞(Chi-Rei Yang)

《Mid-Taiwan Journal of Medicine》 11卷3期 (2006/09) Pp. 201-204

https://doi.org/10.6558/MTJM.2006.11(3).10

摘要

一位52歲女性因兩側腎盂移形細胞癌接受兩側腹腔鏡腎臟輸尿管及膀胱袖口切除手術。術前發現有腎功能不良的情形。她並無其他全身性疾病或急性胰臟炎的危險因子，如膽道結石、喝酒。手術後併發腹脹及血清胰臟酵素劇烈增高（澱粉酶：687U/L，脂肪酶：1342U/L），但是並無上腹痛或轉移性背痛的症狀。術後引流液都很清澈，電腦斷層掃描影像檢查無腸子或胰臟受傷的跡象，臨床表現與典型急性胰臟炎也不相符。她接受部分靜脈營養補充，並在術後15天開始進食。進食後並無腹部不適情形，然而胰臟酵素在術後五個月仍然偏高（澱粉酶：346U/L，脂肪酶，423U/L）。

關鍵字

澱粉酶 ； 腹腔鏡腎臟切除手術 ； 脂肪酶

並列摘要

A 52-year-old female underwent transperitoneal laparoscopic bilateral nephroureterectomy with bladder cuff excision to treat transitional cell carcinoma of renal pelvis. Chronic renal insufficiency was noted before the operation. She did not have other systemic diseases or risk factors of acute pancreatitis such as biliary stone or alcoholism. Abdominal fullness with high levels of pancreatic enzymes (amylase: 687 U/L; lipase: 1342 U/L) were noted postoperatively. There were no symptoms of epigastragia or radiating back pain. The drainage fluid was clear and abdominal computed tomography did not reveal evidence of intestinal or pancreatic injuries. The clinical course was not compatible with typical acute pancreatitis. She received partial parenteral nutrition and started oral feeding 15 days after the operation. The patient no longer complained of having abdominal discomfort but high levels of pancreatic enzymes (amylase: 346 U/L, lipase: 423 U/L) were still noted five months after the operation.

並列關鍵字

amylase ； laparoscopic nephrectomy ； lipase