Significance of Amylase Monitoring in Peritoneal Drainage Fluid after Splenectomy: A Clinical Analysis of Splenectomy in 167 Patients with Hepatolenticular Degeneration

Abstract

Different kinds of complications after splenectomy in hepatolenticular degeneration patients with hypersplenism have been reported in the past decades, but studies on pancreatic fistula and the corresponding targeted prevention and treatment after splenectomy still remain much unexplored. The present work investigated the pathogenic factors of pancreatic fistula after splenectomy and the variation tendency of amylase in drainage fluid, aiming to verify the significance of monitoring amylase in the abdominal drainage fluid in the early diagnosis of pancreatic fistula after splenectomy. One hundred sixty-seven patients with hepatolenticular degeneration and hypersplenism who underwent splenectomy in the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2016 to August 2018 were selected and analyzed. The amylase in the abdominal drainage fluid was monitored routinely after splenectomy. We also conducted the statistics on the incidence of different types of pancreatic fistula and analyzed the influence factors of pancreatic fistula formation. After splenectomy, biochemical fistula occurred in 11 patients (6.6%), grade B fistula in six patients (3.6%), grade C fistula in one patient (0.6%), and the incidence of pancreatic fistula was 4.2 per cent (biochemical fistula excluded). The amylase in the peritoneal drainage fluid was closely concerned with the incidence of pancreatic fistula according to our statistics. Furthermore, by analyzing the different influence factors of pancreatic fistula, Child-Pugh grading of liver function ( P = 0.041), pancreatic texture ( P = 0.029), degree of splenomegaly ( P = 0.003), and operative method ( P = 0.001) were supposed to be closely related to the formation of pancreatic fistula. Monitoring of amylase in peritoneal drainage fluid is regarded as an important physiological parameter in the early diagnosis of pancreatic fistula after splenectomy, which provides effective clinical reference and plays a significant role in preventing the occurrence and development of pancreatic fistula.

Research on Portal Venous Hemodynamics and Influencing Factors of Portal Vein System Thrombosis for Wilson’s Disease after Splenectomy

“…We indicate a rise in PLT plasma for every unit (1 × 10 9 L) along with a parallel increase in D-D substance by 0.017 units. However, P-sel is highly expressed before surgery as a specific indicator of platelet activation function ( 3 ). Injuries of the inner wall of the vein also help PVST formation.…”

“…However, the occurrence of “bone marrow suppression” and the presence of hypersplenism complicate the continuation of copper repellent therapy. Therefore, splenectomy is suggested to relieve hypersplenism and achieve lifetime copper repellent treatment for WD patients ( 3 ).…”

Pancreatic Fistula and Biochemical Leak after Splenectomy: Incidence and Risk Factors—A Retrospective Single-Center Analysis

“…POPF is a well-known and dreaded complication in pancreatic surgery but can also occur after other abdominal procedures [ 6 , 12 – 14 ]. The development of POPF after splenectomy has been studied but the topic remains somewhat neglected [ 23 , 26 ]. Here, we investigate the incidence and risk factors of POPF and BL following splenectomy in a retrospective single-center study of 247 patients who underwent splenectomy over ten years.…”

“…Totally, 14.6% of the patients developed POPF or BL. Unlike authors like Shen et al, we included BL in our analysis and hence report a higher incidence [ 26 ]. When excluding BL to focus solely on clinically relevant POPF (POPF of grade B/C), we report an incidence of 4.5%, which is comparable to the literature [ 26 ].…”

“…Only limited data are available regarding the association of splenectomy (especially PSE) and POPF; a couple of studies report data on POPF after splenectomy in selected patients suffering from liver cirrhosis or hepatolenticular degeneration [ 17 , 26 ]. All other available data were retrieved from SSE patients, in whom splenectomy was part of the surgery but not the primary target [ 10 , 16 , 22 ].…”