Drain amylase value as an early predictor of pancreatic fistula after cephalic duodenopancreatectomy

Abstract

DFA1 ≥ 1200 U/L is an important predictive factor for PF of any degree. The trend of DFA3 (decrease of < 50%) compared to DFA1 is a significant factor in the differentiation of CRPF from transient BPF.

Surgical outcomes for duodenal adenoma and adenocarcinoma: a multicentre study in Australia and the United Kingdom

“…The placement of surgical drain tubes allows early detection of pancreatic leak by measuring post-operative drain tube fluid amylase. 12,13 In addition, it may serve to establish a controlled pancreatico-cutaneous fistula to minimize the degree of sepsis if pancreatic leak is present. However, drain tube placement carries potential infection risk.…”

Meta-analysis of drain amylase content on postoperative day 1 as a predictor of pancreatic fistula following pancreatic resection

“…Early prediction of the likely non‐occurrence of a POPF would be clinically useful, allowing a patient to be placed safely on a fast‐track postoperative protocol. Several preoperative, intraoperative and postoperative risk factors have been analysed previously and found to be associated with POPF.…”

Systematic review and meta-analysis of pancreatic amylase value on postoperative day 1 after pancreatic resection to predict postoperative pancreatic fistula

“…4,7,[17][18][19][20][21][22][23][24][25][26][27][28][29] The process of selecting trials for inclusion is shown in Figure 1. The characteristics of these 15 studies are shown in Table 1.…”

“…The Fagan plot in DPA1 for overall POPF [17][18][19][20][21][22][24][25][26][27][28][29] calculated that the positive post-test probabilities (post-test (þ)) were 0.57, 0.80, 0.92 respectively, and the negative posttest probabilities (post-test (À)) were 0.04, 0.10, 0.25 respectively when the pretest probability was 25% or 50% or 75%. For PPA1 [22,[27][28][29], the post-tests (þ) were 0.39, 0.66, 0.85 respectively, and the post-tests (À) were 0.12, 0.30, 0.56 respectively.…”

“…For clinically relevant POPF, DPA1 [4,7,23,25] was demonstrated that the post-tests (þ) were 0.61, 0.82, 0.93 respectively, and the post-tests (À) were 0.08, 0.20, 0.43 when the pretest probability was 25% or 50% or 75%.…”