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  • Intra-operative amylase in peri-pancreatic fluid independently predicts for pancreatic fistula post pancreaticoduodectomy

    Author(s)
    de Reuver, Philip R
    Gundara, Justin
    Hugh, Thomas J
    Samra, Jaswinder S
    Mittal, Anubhav
    Griffith University Author(s)
    Gundara, Justin
    Year published
    2016
    Metadata
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    Abstract
    Background: Post-operative pancreatic fistula (POPF) is a common and potentially life-threatening complication following pancreaticoduodectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after resection for the diagnosis of POPF. Methods: Consecutive patients who underwent a pancreaticoduodectomy between September 2014 and October 2015 were included in the analysis. IOAC was measured intraoperatively followed by drain fluid analysis for amylase on post-operative days (POD) 1, 3 and 5. Receiver operator characteristic (ROC) analysis was ...
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    Background: Post-operative pancreatic fistula (POPF) is a common and potentially life-threatening complication following pancreaticoduodectomy. The aim of this study was to assess the predictive value of intra-operative amylase concentration (IOAC) in peri-pancreatic fluid after resection for the diagnosis of POPF. Methods: Consecutive patients who underwent a pancreaticoduodectomy between September 2014 and October 2015 were included in the analysis. IOAC was measured intraoperatively followed by drain fluid analysis for amylase on post-operative days (POD) 1, 3 and 5. Receiver operator characteristic (ROC) analysis was performed to evaluate the discriminative capacity of IOAC as a predictor of POPF. Results: IOAC was measured after pancreaticoduodectomy in 62 patients. The IOAC correlated significantly with i) POD 1 and 3 drain amylase (p < 0.01), ii) the development of POPF (p < 0.01), iii) the development of clinically relevant fistula (Type B, C) (p < 0.01), iv) delayed gastric emptying (p < 0.01), and v) grade of complication as per the Clavien-Dindo definition (p = 0.02). ROC curve analysis confirmed the predictive relationship of IOAC and POPF as a good test with an area under the curve of 0.93, 95% CI 0.87–0.99, p < 0.01. In patients with IOAC of 200 U/L or higher the POPF rate was 80% (OR = 50.1, p < 0.0001). Discussion: Measurement of IOAC allows early and accurate categorization of patients at risk for POPF.
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    Journal Title
    HPB
    Volume
    18
    Issue
    7
    DOI
    https://doi.org/10.1016/j.hpb.2016.05.007
    Subject
    Clinical sciences
    Science & Technology
    Life Sciences & Biomedicine
    Gastroenterology & Hepatology
    Surgery
    INTERNATIONAL STUDY-GROUP
    Publication URI
    http://hdl.handle.net/10072/409640
    Collection
    • Journal articles

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