Utility of drain fluid amylase measurement on the first postoperative day after distal pancreatectomy.

Vass, David G and Hodson, James and Isaac, John and Marudanayagam, Ravi and Muiesan, Paolo and Mirza, Darius F and Roberts, Keith and Muiesan, Robert P (2018) Utility of drain fluid amylase measurement on the first postoperative day after distal pancreatectomy. HPB : the official journal of the International Hepato Pancreato Biliary Association, 20 (9). pp. 803-808. ISSN 1477-2574. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c bu using their UHB Athens login IDs

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Official URL: https://www.hpbonline.org/article/S1365-182X(17)30...

Abstract

BACKGROUND

Early exclusion of a postoperative pancreatic fistula (POPF) may facilitate earlier drain removal in selected patients after distal pancreatectomy. The purpose of this study was to evaluate the role of first postoperative day drain fluid amylase (DFA1) measurement to predict POPF.

METHODS

Patients in whom DFA1 was measured after distal pancreatectomy were identified from a prospectively maintained database over a five-year period. A cut-off value of DFA1 was derived using ROC analysis, which yielded sensitivity and negative predictive value of 100% for excluding POPF.

RESULTS

DFA1 was available in 53 of 138 (38%) patients who underwent distal pancreatectomy. 19 of 53 patients (36%) developed a pancreatic fistula (Grade A - 15, Grade B - 3, Grade C - 1). Median DFA1 was significantly higher in those who developed a pancreatic fistula (5473; range 613-28,450) compared those without (802; range 57-2350). p < 0.0001. Using ROC analysis, a DFA1 less than 600 excluded pancreatic fistula with a sensitivity of 100% (AUROC of 0.91; SE = 0.04, p < 0.001).

CONCLUSION

First postoperative day drain fluid amylase measurement may have a role in excluding pancreatic fistula after distal pancreatectomy. Such patients may be suitable for earlier drain removal.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c bu using their UHB Athens login IDs
Subjects: WI Digestive system. Gastroenterology
Divisions: Planned IP Care > Gastroentrology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 23 Sep 2019 10:50
Last Modified: 02 Oct 2019 15:03
URI: http://www.repository.uhblibrary.co.uk/id/eprint/2400

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