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J Gastrointest Surg. 2014 Feb;18(2):348-53. doi: 10.1007/s11605-013-2293-3. Epub 2013 Aug 1.

Postoperative serum amylase predicts pancreatic fistula formation following pancreaticoduodenectomy.

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1
Department of Surgery, Stanford University, 300 Pasteur Dr, H3591, Stanford, CA, 94305, USA.

Abstract

INTRODUCTION:

Early identification of patients at risk for developing pancreatic fistula (PF) after pancreaticoduodenectomy (PD) may facilitate prevention or treatment strategies aimed at reducing its associated morbidity.

MATERIALS AND METHODS:

A retrospective review of 176 consecutive PD performed between 2006 and 2011 was conducted in order to analyze the association between the serum amylase on postoperative day 1 (POD1) and the development of PF.

RESULTS:

Serum amylase was recorded on POD1 in 146 of 176 PD cases (83.0 %). Twenty-seven patients (18.5 %) developed a postoperative PF: 6 type A, 19 type B, and 2 type C. Patients with a PF had a mean serum amylase on POD1 of 659 ± 581 compared to 246 ± 368 in those without a fistula (p < 0.001). On logistic regression, a serum amylase >140 U/L on POD1 was strongly associated with developing a PF (OR, 5.48; 95 % CI, 1.94-15.44). Sensitivity and specificity of a postoperative serum amylase >140 U/L was 81.5 and 55.5 %, respectively. Positive and negative predictive values were 29.3 and 93.0 %, respectively.

CONCLUSION:

An elevated serum amylase on POD1 may be used, in addition to other prognostic factors, to help stratify risk for developing PF following PD.

PMID:
23903930
DOI:
10.1007/s11605-013-2293-3
[Indexed for MEDLINE]
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