Amylase value in drains after pancreaticoduodenectomy as predictive factor of grade B and C postoperative pancreatic fistula_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

MA Chunlong ¹ ,  HAN Wei ²

1. Xinjiang Medical University, Urumqi 830000, P. R. China;
2. The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, P. R. China;

Corresponding author：

HAN Wei, Email: 13999846637@139.com

Keywords：

pancreaticoduodenectomy; intraperitoneal drainage fluid; amylase; pancreatic fistula

DOI：

10.7507/1007-9424.201903106

Video：

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Objective To investigate predictive value of amylase level in intraperitoneal drainage fluid after pancreaticoduodenectomy (PD) for grade B and C pancreatic fistula (PF).Method The clinical data of 106 patients underwent PD in the First Affiliated Hospital of Xinjiang Medical University from June 2014 to June 2018 were retrospectively analyzed.Results Twenty-four cases (22.6%) had the PF after the PD, in which of 18 cases of grade A, 4 cases of grade B, and 2 cases of grade C. The age, tumor diameter, pancreatic texture, and main pancreatic duct diameter were associated with the PF after the PD by the univariate analysis (P<0.050), the main pancreatic duct diameter (OR=4.856, P=0.004) was its independent risk factor. The amylase levels of intraperitoneal drainage fluid on day 5, 7, and 10 after the PD could better predict the occurrence of PF (AUC was 0.910, 0.951, 0.948, respectively), especially which on day 10 after the PD could better predict the occurrence of grade B and C PF (AUC was 0.938).Conclusion Elevated amylase levels in peritoneal drainage fluid on day 5, 7, and 10 after PD have better diagnostic effects on PF, especially which on day 10 after PD has a better diagnostic effect on grade B and C PF.

Citation： MA Chunlong, HAN Wei. Amylase value in drains after pancreaticoduodenectomy as predictive factor of grade B and C postoperative pancreatic fistula. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(8): 939-942. doi: 10.7507/1007-9424.201903106 Copy

1.	Ramacciato G, Mercantini P, Petrucciani N, et al. Risk factors of pancreatic fistula after pancreaticoduodenectomy: a collective review. Am Surg, 2011, 77(3): 257-269.
2.	赵玉沛. 胰腺术后外科常见并发症诊治及预防的专家共识(2017). 协和医学杂志, 2017, 8(2): 139-146.
3.	Mitra A, D’Souza A, Goel M, et al. Surgery for pancreatic and periampullary carcinoma. Indian J Surg, 2015, 77(5): 371-380.
4.	El Nakeeb A, Salah T, Sultan A, et al. Pancreatic anastomotic leakage after pancreaticoduodenectomy. Risk factors, clinical predictors, and management (single center experience). World J Surg, 2013, 37(6): 1405-1418.
5.	Poon RT, Lo SH, Fong D, et al. Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy. Am J Surg, 2002, 183(1): 42-52.
6.	Vollmer CM Jr, Sanchez N, Gondek S, et al. A root-cause analysis of mortality following major pancreatectomy. J Gastrointest Surg, 2012, 16(1): 89-102.
7.	Shrikhande SV, D’Souza MA. Pancreatic fistula after pancreatectomy: evolving definitions, preventive strategies and modern management. World J Gastroenterol, 2008, 14(38): 5789-5796.
8.	Lin JW, Cameron JL, Yeo CJ, et al. Risk factors and outcomes in postpancreaticoduodenectomy pancreaticocutaneous fistula. J Gastrointest Surg, 2004, 8(8): 951-959.
9.	Ahmad SA, Edwards MJ, Sutton JM, et al. Factors influencing readmission after pancreaticoduodenectomy: a multi-institutional study of 1 302 patients. Ann Surg, 2012, 256(3): 529-537.
10.	Kastenberg ZJ, Morton JM, Visser BC, et al. Hospital readmission after a pancreaticoduodenectomy: an emerging quality metric? HPB (Oxford), 2013, 15(2): 142-148.
11.	Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery, 2017, 161(3): 584-591.
12.	吴耐, 张蓬波, 任泽强. 胰十二指肠切除术后胰瘘发生的危险因素及风险预测. 中国普外基础与临床杂志, 2018, 25(7): 889-894.
13.	Molinari E, Bassi C, Salvia R, et al. Amylase value in drains after pancreatic resection as predictive factor of postoperative pancreatic fistula: results of a prospective study in 137 patients. Ann Surg, 2007, 246(2): 281-287.
14.	Sutcliffe RP, Battula N, Haque A, et al. Utility of drain fluid amylase measurement on the first postoperative day after pancreaticoduodenectomy. World J Surg, 2012, 36(4): 879-883.
15.	Shinchi H, Wada K, Traverso LW. The usefulness of drain data to identify a clinically relevant pancreatic anastomotic leak after pancreaticoduodenectomy? J Gastrointest Surg, 2006, 10(4): 490-498.
16.	Sato N, Tamura T, Minagawa N, et al. Preoperative body mass index-to-prognostic nutritional index ratio predicts pancreatic fistula after pancreaticoduodenectomy. Hepatobiliary Surg Nutr, 2016, 5(3): 256-262.

1. Ramacciato G, Mercantini P, Petrucciani N, et al. Risk factors of pancreatic fistula after pancreaticoduodenectomy: a collective review. Am Surg, 2011, 77(3): 257-269.
2. 赵玉沛. 胰腺术后外科常见并发症诊治及预防的专家共识(2017). 协和医学杂志, 2017, 8(2): 139-146.
3. Mitra A, D’Souza A, Goel M, et al. Surgery for pancreatic and periampullary carcinoma. Indian J Surg, 2015, 77(5): 371-380.
4. El Nakeeb A, Salah T, Sultan A, et al. Pancreatic anastomotic leakage after pancreaticoduodenectomy. Risk factors, clinical predictors, and management (single center experience). World J Surg, 2013, 37(6): 1405-1418.
5. Poon RT, Lo SH, Fong D, et al. Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy. Am J Surg, 2002, 183(1): 42-52.
6. Vollmer CM Jr, Sanchez N, Gondek S, et al. A root-cause analysis of mortality following major pancreatectomy. J Gastrointest Surg, 2012, 16(1): 89-102.
7. Shrikhande SV, D’Souza MA. Pancreatic fistula after pancreatectomy: evolving definitions, preventive strategies and modern management. World J Gastroenterol, 2008, 14(38): 5789-5796.
8. Lin JW, Cameron JL, Yeo CJ, et al. Risk factors and outcomes in postpancreaticoduodenectomy pancreaticocutaneous fistula. J Gastrointest Surg, 2004, 8(8): 951-959.
9. Ahmad SA, Edwards MJ, Sutton JM, et al. Factors influencing readmission after pancreaticoduodenectomy: a multi-institutional study of 1 302 patients. Ann Surg, 2012, 256(3): 529-537.
10. Kastenberg ZJ, Morton JM, Visser BC, et al. Hospital readmission after a pancreaticoduodenectomy: an emerging quality metric? HPB (Oxford), 2013, 15(2): 142-148.
11. Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery, 2017, 161(3): 584-591.
12. 吴耐, 张蓬波, 任泽强. 胰十二指肠切除术后胰瘘发生的危险因素及风险预测. 中国普外基础与临床杂志, 2018, 25(7): 889-894.
13. Molinari E, Bassi C, Salvia R, et al. Amylase value in drains after pancreatic resection as predictive factor of postoperative pancreatic fistula: results of a prospective study in 137 patients. Ann Surg, 2007, 246(2): 281-287.
14. Sutcliffe RP, Battula N, Haque A, et al. Utility of drain fluid amylase measurement on the first postoperative day after pancreaticoduodenectomy. World J Surg, 2012, 36(4): 879-883.
15. Shinchi H, Wada K, Traverso LW. The usefulness of drain data to identify a clinically relevant pancreatic anastomotic leak after pancreaticoduodenectomy? J Gastrointest Surg, 2006, 10(4): 490-498.
16. Sato N, Tamura T, Minagawa N, et al. Preoperative body mass index-to-prognostic nutritional index ratio predicts pancreatic fistula after pancreaticoduodenectomy. Hepatobiliary Surg Nutr, 2016, 5(3): 256-262.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Amylase value in drains after pancreaticoduodenectomy as predictive factor of grade B and C postoperative pancreatic fistula

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