Amylase Value in Drains After Pancreatic Resection as Predictive Factor of Postoperative Pancreatic Fistula

Abstract

AVD in POD1 > or =5000 U/L is the only significant predictive factor of PF development.

Utility of CT in the Diagnosis of Pancreatic Fistula After Pancreaticoduodenectomy in Patients with Soft Pancreas

“…Using the definition proposed by the International Study Group on Pancreatic Fistula [11], we made the diagnosis of pancreatic fistula on postoperative day 7 in the cases of 22 of the 27 patients (81%) with pancreatic fistula. This result confirms the high sensitivity (70-75%) of clinical and biologic criteria for the diagnosis of pancreatic fistula reported in the literature [14,16,17]. CT performed on postoperative day 7 depicted a perianastomotic collection in 13 of our 22 patients (59%) with overt pancreatic fistula.…”

“…Pancreatic fistula diagnosed with repeated assays of pancreatic enzymes in peripancreatic fluid drainage [11,14,16] © American Roentgen Ray Society P ancreaticoduodenectomy is safe in the management of various malignant and benign diseases of the pancreatic head and periampullary region. Although the mortality rate has decreased to approximately 1-2% at high-volume centers, the morbidity rate ranges from 30% to 50% [1][2][3][4].…”

“…The interval between surgery and CT was based on observations that the diagnosis of pancreatic fistula is made an average of 7 days after pancreaticoduodenectomy [5,14,15]. One study [26] showed that a fluid collection seen around the pancreaticojejunostomy site and in the pancreatic bed on CT images may be caused by pancreatic fistula in patients who have undergone pancreaticoduodenectomy.…”

“…Soft pancreatic texture [1,3,13] and small pancreatic duct size [3] are the most important preoperative risk factors for the development of pancreatic fistula.The diagnosis of pancreatic fistula usually is made an average of 7 days after pancreaticoduodenectomy [5,14,15]. Pancreatic fistula diagnosed with repeated assays of pancreatic enzymes in peripancreatic fluid drainage [11,14,16] © American Roentgen Ray Society P ancreaticoduodenectomy is safe in the management of various malignant and benign diseases of the pancreatic head and periampullary region.…”

Division of surgeon workload in pancreaticoduodenectomy: striving to decrease post‐operative pancreatic fistula

“…It is generally reported that the incidence of clinically relevant post‐operative pancreatic fistulas after PD is 7.6–36.4%,1, 2, 3, 4, 5 in accordance to the definition of the International Study Group of Pancreatic Fistula (ISGPF) 6. Researchers have suggested factors that affect pancreatic leakage after PD, including male gender, advanced age, post‐operative albumin level, intraoperative bleeding, soft pancreatic parenchyma, small pancreatic duct, drain amylase level on post‐operative day one, pancreatic parenchymal thickness and surgeon volume, among others 1, 7, 8, 9, 10, 11, 12, 13, 14…”