Amylase concentration in drainage fluid as a predictive factor for severe postoperative pancreatic fistula in patients with gastric cancer

Yoshiki Taniguchi, Yukinori Kurokawa, Jota Mikami, Koji Tanaka, Yasuhiro Miyazaki, Tomoki Makino, Tsuyoshi Takahashi, Makoto Yamasaki, Kiyokazu Nakajima, Shuji Takiguchi, Masaki Mori, Yuichiro Doki

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5 Citations (Scopus)

Abstract

Purpose: Postoperative pancreatic fistula (PPF) sometimes occurs after gastrectomy. We examined the risk factors for severe PPF and evaluated the predictive value of amylase concentration in drainage fluid. Methods: We retrospectively reviewed 591 patients who underwent curative gastrectomy for gastric cancer. A multivariate analysis was conducted to identify the risk factors for severe PPF. Receiver operating characteristic curves were used to identify the appropriate amylase cut-off value to predict severe PPF. Results: Severe PPF occurred in 23 (3.9%) cases. The multivariate analysis indicated that splenectomy (P = 0.009) was the only significant risk factor. The area under the curve of amylase in drainage fluid for predicting severe PPF on postoperative day (POD) 3 was much greater than that on POD 1 (0.972 vs. 0.894). When the cut-off values for amylase were determined to be 2900 U/L on POD 1 and 2100 U/L on POD 3, the risk ratio for severe PPF on POD 3 was higher than that on POD 1 (99.2 vs. 30.2). Conclusions: Splenectomy was an independent risk factor for severe PPF. An amylase level of 2100 U/L on POD 3 may be a reliable cut-off value for the early diagnosis of patients at high risk of severe PPF.

Original languageEnglish
Pages (from-to)1378-1383
Number of pages6
JournalSurgery Today
Volume47
Issue number11
DOIs
Publication statusPublished - Nov 1 2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery

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    Taniguchi, Y., Kurokawa, Y., Mikami, J., Tanaka, K., Miyazaki, Y., Makino, T., Takahashi, T., Yamasaki, M., Nakajima, K., Takiguchi, S., Mori, M., & Doki, Y. (2017). Amylase concentration in drainage fluid as a predictive factor for severe postoperative pancreatic fistula in patients with gastric cancer. Surgery Today, 47(11), 1378-1383. https://doi.org/10.1007/s00595-017-1521-y