Amylase in drain fluid for the diagnosis of pancreatic leak in post-pancreatic resection

Abstract

Because of the paucity of data and methodological deficiencies in the studies, we are uncertain whether drain fluid amylase should be used as a method for testing for pancreatic leak in an unselected population after pancreatic resection; and we judge that the optimal cut-off of drain fluid amylase for making the diagnosis of pancreatic leak is also not clear. Further well-designed diagnostic test accuracy studies with pre-specified index test threshold of drain fluid amylase (at three times more on postoperative day 5 or another suitable pre-specified threshold), appropriate follow-up (for at least six to eight weeks to ensure that there are no pancreatic leaks), and clearly defined reference standards (of surgical, clinical, and radiological confirmation of pancreatic leak) are important to reliably determine the diagnostic accuracy of drain fluid amylase in the diagnosis of pancreatic leak.

First‐day plasma amylase detects patients at risk of complications after simultaneous pancreas‐kidney transplantation

“…When comparing CRP and plasma amylase in our cohort, the latter was significantly better in predicting complications. While drain fluid amylase is routinely used as a diagnostic marker for pancreas‐related complications after general pancreatic surgery, no relevant studies investigating its role in pancreas transplantation could be found 20 . Our results show that drain fluid amylase could be nearly as good as plasma amylase in predicting severe pancreas graft‐related complications, but plasma amylase showed more significant AUC values and was more precise in dividing patients between high and low morbidity groups, and for this reason, it was chosen as the primary variable.…”

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

“…The 2017 Cochrane review reported great variability in reporting of POPF, in terms of operative days and different cut-off values 15. Some studies identified a patient with pancreatic fistula after radiological confirmation, before using ISGPF classification to stratify POPF.…”

Intraoperative Radiation Therapy Induces Immune Response Activity after Pancreatic Surgery

“…[38] Throughout the abdominal cavity, drainage uid from pancreatic cancer patients has only been used as a diagnostic indicator of pancreatic leaks or ascites, unlike wound uid from breast cancer surgery. [39,40] Various cancers, including pancreatic cancer, are known to protect malignant cells and accumulate uid (malignant effusion) through the secretion of cytokines, growth factors, or peptides. [41] Several studies have investigated the tumour microenvironment through PF analysis for other cancer types, but little research has been conducted on PF in pancreatic cancer to date.…”