Analysis of prognostic factors for hyperamylasemia following pancreaticoduodenectomy
10.3760/cma.j.issn.0529-5815.2019.07.011
- VernacularTitle: 胰十二指肠切除术后高淀粉酶血症的预后因素分析
- Author:
Huan WANG
1
;
Zhuo SHAO
;
Shiwei GUO
;
Wei JING
;
Bin SONG
;
Gang LI
;
Tianlin HE
;
Xuyu ZHOU
;
Yijie ZHANG
;
Yingqi ZHOU
;
Xiangui HU
;
Gang JIN
Author Information
1. Department of Hepato-Biliary-Pancreatic Surgery, Changhai Hospital, Navy Medical University, Shanghai 200433, China
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Hyperamylasemia;
Postoperative pancreatic fistula;
Complication;
Prognostic factors
- From:
Chinese Journal of Surgery
2019;57(7):534-539
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the prognostic factors of hyperamylasemia following pancreaticoduodenectomy (PD) .
Methods:Clinical data of 359 patients were collected prospectively who underwent PD by the same group at Changhai Hospital of Navy Medical University from January 2017 to June 2018.There were 212 males and 147 females.The median age was 63 years old (range: 23 to 82 years old) .According to whether the patient′s serum amylase was greater than 120 U/L at 0 or 1 day after surgery,the patients were divided into hyperamylasemia group and non-hyperamylasemia group. Univariate analysis and multivariate analysis were used to find out the prognostic factors of hyperamylasemia after PD.
Results:Of the 359 patients, 238 cases (66.3%) developed hyperamylasemia.The incidence rate of clinically related pancreatic fistula (15.1% vs.2.5%, P<0.01) , grade B/C post pancreatectomy hemorrhage (8.8% vs. 2.5%, P<0.01) , and surgical site infection (9.2% vs. 3.3%, P=0.04) was significantly higher in the hyperamylasemia group.The severity of complications (CD grade≥Ⅲ: 11.3% vs.4.1%, P=0.023) and postoperative hospital stay (11 days vs. 9 days, P=0.001) were higher in the hyperamylasemia group.In the multivariate analysis, the main pancreatic duct diameter (MPD) ≤3 mm (OR=4.469, 95% CI: 2.563-7.793, P<0.01) , pathological type of disease (pancreatic cancer or pancreatitis) (OR=0.230, 95% CI: 0.122-0.436, P<0.01) and soft texture of pancreas (OR=3.297, 95%CI: 1.930-5.635, P<0.01) were independent prognostic factors for hyperamylasemia.
Conclusions:Post-PD hyperamylasemia increased the incidence and severity of postoperative complications after PD.MPD≤3 mm, soft texture of pancreas and pathological type of disease were independent prognostic factors of hyperamylasemia.
