Pancreatitis Following Scoliosis Surgery and Associated Risk Factors

Postoperative pancreatitis in addition to surgeries involving the biliary ducts, the pancreas, or the surrounding organs, occurs in scoliosis surgery, with prevalence rates of 16-19%. This study was designed and conducted to determine the prevalence of pancreatitis following scoliosis surgery and its associated risk factors.In a cross-sectional descriptive study, we enrolled 50 patients underwent surgery for correction of scoliosis at two hospitals in Tehran, Iran, between November 2006 and June 2007. Levels of serum amylase and lipase were measured before and two days after surgery. Duration of fasting after surgery, clinical signs of pancreatitis, duration of hospital stay, length of surgery, original curvature of the spine and degree of correction after surgery, and demographic data were recorded. The diagnosis of subclinical or biochemical pancreatitis was established with trebling of serum amylase and lipase.Twenty-seven of patients (54%) developed postoperative pancreatitis following scoliosis surgery. Sex, type of scoliosis, type of surgery, correction of Cobb's angle, and length of surgery were not found to correlate with the incidence of pancreatitis, whereas a significant relationship was found between the volume of hemorrhage and the incidence of pancreatitis (p < 0.05).The higher prevalence of pancreatitis in this study (54%) may be due to pancreatic ischemia. Patients are prone to ischemia owing to massive intraoperative bleeding and hypotensive anesthesia directed to reduce it. In this study patients developed pancreatitis were found to have lost more blood during surgery. This study demonstrated that pancreatitis can develop as a complication of the single-stage or two-stage surgery for correction of scoliosis and can dramatically affect patient outcome; hence we recommend that patients undergoing scoliosis surgery be monitored for increase in serum amylase and lipase, as well as any suggestive signs of clinical pancreatitis.