Role of intraoperative amylase from the pancreatic stump in predicting the presence of pancreatic fistula
10.3760/cma.j.issn.1674-1935.2019.04.005
- VernacularTitle:术中胰腺残端淀粉酶测定对术后胰瘘的预测作用
- Author:
Weishen WANG
1
;
Hao QIAN
;
Jiewei LIN
;
Yuanchi WENG
;
Jun ZHANG
;
Jiancheng WANG
Author Information
1. 上海交通大学医学院附属瑞金医院普通外科
- Keywords:
Pancreatectomy;
Pancreatic fistula;
Intraoperative amylase;
Forecasting
- From:
Chinese Journal of Pancreatology
2019;19(4):261-264
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the predictive role of the intraoperative amylase ( IOA ) from pancreatic stump for postoperative pancreatic fistula. Methods The clinical data of 26 patients who received distal pancreatectomy ( DP) and central pancreatectomy ( CP) in the Shanghai Ruijin Hospital from June 2017 to July 2018 were retrospectively analyzed. IOA and peri-operative potential clinical factors associated with pancreatic fistula were analyzed. Receiver operating characteristics ( ROC) curve was drawn to evaluate the diagnostic efficacy of IOA from pancreatic stump in predicting postoperative pancreatic fistula, and the sensitivity and specificity were calculated. Results Of 26 patients, 19 patients underwent DP and 7 patients underwent CP. 9 patients (34.6％,9/26)had class A pancreatic fistula (biochemical leak) and 11 patients (42. 3％,11/26) had class B pancreatic fistula after surgery, and no class C pancreatic fistula occurred. Univariate analysis showed that IOA from pancreatic stump in clinically relevant pancreatic fistula group was higher than that in clinically irrelevant pancreatic fistula group(7971. 82 ± 4387. 98 vs 1589. 20 ± 1405. 00, P=0. 001). Area under the curve ( AUC) of IOA in predicting the development of clinically relevant pancreatic fistula after surgery was 0. 921 and 95％ confidential interval was 0. 807-1. 000. The optimal cut-off value was 3622 U/L , and the sensitivity and specificity were 90. 9％ and 86. 7％. Conclusions IOA from pancreatic stump could serve as a clinical indicator for predicting the occurrence of postoperative pancreatic fistula.
