Amylase value in drains after pancreatoduodenectomy as predictive factor of postoperative pancreatic fistula

Drain fluid biomarkers for prediction and diagnosis of clinically relevant postoperative pancreatic fistula: A narrative review

“…Diagnostic cut-offs for POD3 drain amylase have ranged between 26 U/L and 1026 U/L for distal pancreatectomy cohorts[ 54 , 56 , 92 , 93 ], 93-2820 U/L for pancreatoduodenectomy cohorts[ 55 , 56 , 83 , 84 , 94 - 99 ] and 200-3000 U/L in studies analysing the biomarker in pancreatectomy patients[ 16 , 56 , 75 , 100 - 103 ]. When cut-off accuracy was reported, sensitivity ranged from 0.316-1.00 and specificity, from 0.631-0.968[ 16 , 55 , 75 , 84 , 92 , 94 - 98 , 101 - 103 ], showing drain amylase alone does not completely include or exclude CR-POPF. This reinforces the importance of clinically relevant sequelae developing for accurate diagnosis as stipulated by the consensus definition[ 24 ].…”

“…After distal pancreatectomy, Suzumura et al [ 106 ] identified ≥ 1200 U/L as the predictive cut-off and Hiyoshi’s group reported a sensitivity and specificity of 0.938 and 0.7 for a cut-off of ≥ 800 U/L[ 107 ]. POD5 drain amylase has been significantly correlated with CR-POPF post-pancreatoduodenectomy[ 108 ] where after distal pancreatectomy, a cut-off of > 1000 U/L was significantly associated with CR-POPF[ 109 ], with the cut-off of > 538 U/L by Coayla et al [ 98 ] predicting CR-POPF with a sensitivity and specificity of 0.86 and 0.91 respectively.…”