Abstract:
OBJECTIVES:Amylase level in drains (ALD) has been proposed as a predictor for the development of a clinically significant pancreatic fistula (CS-PF) in patients undergoing a major pancreatic surgery. This study aimed to determine if the ALD in patients who developed a CS-PF after pancreatoduodenectomy is higher than that for patients with transient fistulae and to establish a threshold value as a predictor of a CS-PF. METHODS:From January 2002 to December 2012, all patients undergoing pancreatoduodenectomy were enrolled. At least 1 ALD measurement on postoperative day 3 was obtained. Pancreatic fistula (PF) was defined according to the International Study Group on Pancreatic Fistula. Both grade B and C PFs were considered as a CS-PF. We determined the cutoff value with a receiver operating characteristic curve. RESULTS:A total of 135 patients were enrolled. Pancreatic fistula was diagnosed in 36 cases (26.7%). The ALD median values were the following: PF grade A, 1809 U/L; PF grade B, 19,710 U/L; and PF grade C, 27,590 U/L. A drain amylase value of 2820 U/L was determined to be the cutoff for the development of a CS-PF. CONCLUSIONS:Patients with CS-PF have higher values of ALD than patients who developed a mild/transient fistula. An ALD higher than 2820 U/L identifies patients likely to present a CS-PF.
journal_name
Pancreasjournal_title
Pancreasauthors
Ceroni M,Galindo J,Guerra JF,Salinas J,Martínez J,Jarufe Ndoi
10.1097/MPA.0000000000000060subject
Has Abstractpub_date
2014-04-01 00:00:00pages
462-4issue
3eissn
0885-3177issn
1536-4828pii
00006676-201404000-00022journal_volume
43pub_type
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