Ann Hepatobiliary Pancreat Surg.  2018 Nov;22(4):397-404. 10.14701/ahbps.2018.22.4.397.

Predictive value of post-operative drain amylase levels for post-operative pancreatic fistula

• Serene TE
• G SV
• Padmakumar JS
• Terence HC
• Keem LJ
• Bei W
• Winston WW

• KMID: 2427372
• DOI: http://doi.org/10.14701/ahbps.2018.22.4.397

Abstract

BACKGROUNDS/AIMS
Traditionally, surgically placed pancreatic drains are removed, at the discretion of the operating surgeon. Moving towards enhanced recovery after surgery (ERAS), we looked for predictors for early drain removal. The purpose of this paper was to establish which postoperative days' (POD) drain amylase is most predictive against post-operative pancreatic fistula (POPF).
METHODS
We conducted a retrospective study of 196 patients who underwent pancreatic resection at our institute from January 2006 to October 2013. Drain amylase levels were routinely measured. The International Study Group of Pancreatic Fistula (ISGPF) definition of POPF, and clinical severity grading were used.
RESULTS
5.1% (10 of 196) patients developed ISGPF Grades B and C POPF. Negative predictive value of developing significant POPF, if drain amylase values were low on PODs 1 and 3 was 98.7% (95% CI: 0.93-1.00). This translated to confidence in removing surgically placed pancreatic drains, at POD 1 and 3 when drain amylase values are low.
CONCLUSIONS
Patients with low drain amylase values on POD 1 and 3, are unlikely to develop POPF and may have pancreatic drains removed earlier.

Keyword

Pancreatic fistula; Pancreatoduodenectomy; Distal pancreatectomy; Enhanced recovery after surgery

MeSH Terms

Amylases*
Humans
Pancreatic Fistula*
Pancreaticoduodenectomy
Retrospective Studies
Amylases

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