Amylase, lipase, and volume of drainage fluid in gastrectomy for the early detection of complications caused by pancreatic leakage

Seo, Kyung Won; Yoon, Ki Hyun; Lee, Sang Ho; Shin, Yeon Myung; Choi, Kyung Hyun; Hwang, Hyunyong

doi:10.4174/jkss.2011.81.6.402

Cited by 8 publications

(9 citation statements)

References 26 publications

(20 reference statements)

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“…Many authors [ 6 ] consider some parameters: drainage amylase concentration lipase drainage concentration drainage volume. …”

Section: Discussionmentioning

confidence: 99%

“…Drainage fluid was sampled from the left subphrenic cavity in all the cases on days 1[ 5 ] and 3. We also sampled serum amylase and lipase concentration and tube drainage fluid volume in all of the patients [ 6 ].…”

Section: Methodsmentioning

confidence: 99%

“…Amylase concentration of the drainage fluid after surgery for gastric cancer can be considered a useful predictive risk factor for pancreatic-related complications [ 4 - 6 ].…”

Section: Introductionmentioning

confidence: 99%

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The measurement of amylase in drain fluid for the detection of pancreatic fistula after gastric cancer surgery: an interim analysis

et al. 2015

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BackgroundPancreatic fistula is still one of the most serious and potential complications after D2-D3 distal and total gastrectomy (4% to 6%). Despite their importance, pancreatic fistulas still have not been uniformly defined. Amylase concentration of the drainage fluid after surgery for gastric cancer can be considered as a predictive factor of the presence of pancreatic fistula.MethodsFrom January 2009 to April 2013, 53 patients underwent surgery for gastric cancer. Amylase concentration in the drainage fluid was measured on the first postoperative day and if it was ≥1,000 UI, it was measured again on the third postoperative day. Pancreatic fistula occurred in four cases (7.5%). Pancreatic fistulas were classified using the International Study Group on Pancreatic Fistula (ISGPF) criteria into different grades of severity. Two fistulas were Grade A, one was Grade B, and one was Grade C.ResultsManagement of drainage tubes is still crucial after gastrectomy, not only for the likelihood of anastomotic leaks but also the eventual diagnosis and management of pancreatic fistula. High amylase drainage content and then the presence of the pancreatic fistula may be due to several causes: the operation itself when it includes splenectomy or pancreatic tail-splenectomy, the extended lymphadenectomy but even the ‘gently and softly’ pancreatic manipulation, according literature, may be a risk factor.ConclusionsThe authors assessed amylase concentration in the drainage fluid collected from the left subphrenic cavity on POD1 and POD3 in 53 patients who had undergone curative gastrectomy for cancer and concluded that amylase drainage content >3 times the serum amylase was a useful predictive risk factor for pancreatic fistula. Our work is an interim analysis and the aim of this study is to increase the accrual of the number of patients to have a significant number. For this reason, a protocol for a multicenter trial will be designed to verify whether the systematic measurement of amylase in drain fluid is better than abdominal ultrasound for the detection of pancreatic fistula after gastric cancer surgery.

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“…Many authors [ 6 ] consider some parameters: drainage amylase concentration lipase drainage concentration drainage volume. …”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The measurement of amylase in drain fluid for the detection of pancreatic fistula after gastric cancer surgery: an interim analysis

et al. 2015

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“…Amylase concentration in drainage uid after gastric cancer surgery can be considered as an effective predictor of pancreatic related complications [7,11,12]. However, we did not realize to detect the amylase concentration in peritoneal drainage uid until the patients had abnormal symptoms after the therapeutic prone position, which indicated that we lacked prediction in the diagnosis and treatment of the disease.…”

Section: Discussionmentioning

confidence: 89%

Prone position increases the risk of pancreatic fistula after laparoscopic radical gastrectomy combined with heated intraperitoneal chemotherapy: a case report

Weng

et al. 2020

Preprint

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Background: There has not been reported that prone position increases the risk of postoperative pancreatic fistula. We present a case of prone position leading to hyperthermia and pancreatic fistula in a patient with acute respiratory distress syndrome(ARDS) after laparoscopic radical gastrectomy(LRG) combined with heated intraperitoneal chemotherapy(HIPEC).Case presentation: A 68-year-old male developed moderate ARDS after LRG combined with HIPEC. Since low tidal volume and high positive end expiratory pressure(PEEP) ventilation could not improve oxygenation, prone ventilation was selected to improve heterogeneous lung injury. However, chills and fever appeared after the position change. Abdominal computed tomography (CT) showed that the mesenteric fat space in the middle abdomen was fuzzy, local exudation was increased, and the boundary of pancreas was not clear. The increase of amylase in peritoneal drainage fluid was 10 times higher than that in serum amylase. After communicating with the general surgeon, we learned that during the operation, the surgeon had opened the pancreatic capsule to clean the local lymph nodes. It was considered that prone position lead to the sharp increase of abdominal pressure, especially the change of peripancreatic pressure. The visceral organs of the abdominal cavity squeezed each other, the pancreatic tissue was compressed, the pancreatic juice extravasation occurred, and even aggravated the pancreatic fistula. In the follow-up treatment process, the patient were given continuous abdominal drainage and avoided prone position as far as possible. Since then, the patient's temperature tended to be stable. On the 10th day after the operation, the patient successfully withdrew from the ventilator and transferred to the general ward for further specialized treatment.Conclusion: Our case adds further concerns in ARDS patients after LRG combined with HIPEC, including the monitoring of postoperative pancreatic fistula and how to perform prone ventilation more safely.

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“…6 It poses a challenge for surgeons worldwide as it is difficult to manage, is usually associated with long hospital stay, and has high mortality rates that range from 4.8 to 75%. 7 Management of postoperative upper gastrointestinal leakage is usually achieved by reoperation and primary closure of the leakage site, or conservatively by using drains or stents. Converting the leakage site to a controlled fistula in the management of upper gastrointestinal leakage is effective, but usually requires long hospital stay in order to achieve the closure of the leakage site.…”

mentioning

confidence: 99%

Management of Postoperative Gastrointestinal Leakage With Autologous Stromal Vascular Fraction

Aldaqal

Khayat

Bokhary

et al. 2015

International Surgery

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To assess the efficacy of using autologous stromal vascular fraction (SVF) to promote healing of controlled fistula tracts in the management of postoperative upper gastrointestinal leakage. This is an experimental study conducted on 10 experimental rabbits. Animal models were divided into the SVF group which received an autologous SVF and the control group which did not receive the implantation. Surgery was performed on both groups to induce a gastric leak and create a controlled fistula tract between the leakage site in the stomach and the skin. After 2 weeks, surgery was performed on the SVF group to harvest, process and then implant the autologous SVF in the fistula tract. Animal models were followed up and their fistula tracts were evaluated for healing by gross and microscopic examination of the fistula tracts before the SVF implantation and at 24 hours, 1 week, 2 weeks and 3 weeks after implantation. The control group revealed no closure of fistula tracts by the 3 rd week after implantation and there were no signs of inflammation or drainage. On the other hand, the SVF group showed signs of healing process with progressive closure of the fistula tract to about 95% by the 3 rd week after implantation. The use of autologous SVF implantation to promote

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Amylase, lipase, and volume of drainage fluid in gastrectomy for the early detection of complications caused by pancreatic leakage

Cited by 8 publications

References 26 publications

The measurement of amylase in drain fluid for the detection of pancreatic fistula after gastric cancer surgery: an interim analysis

The measurement of amylase in drain fluid for the detection of pancreatic fistula after gastric cancer surgery: an interim analysis

Prone position increases the risk of pancreatic fistula after laparoscopic radical gastrectomy combined with heated intraperitoneal chemotherapy: a case report

Management of Postoperative Gastrointestinal Leakage With Autologous Stromal Vascular Fraction

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