Sequential drain amylase to guide drain removal following pancreatectomy.

Autor:	Villafane-Ferriol N; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Van Buren G 2nd; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Mendez-Reyes JE; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., McElhany AL; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Massarweh NN; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Silberfein EJ; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Hsu C; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Tran Cao HS; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Schmidt C; The Ohio State University, Department of Surgery, M256 Starling Loving Hall, 320W 10th Avenue, Columbus, OH 43210, USA., Zyromski NJ; Indiana University School of Medicine, Department of Surgery, 545 Barnhill Drive EH 519, Indianapolis, IN 46202, USA., Dillhoff ME; The Ohio State University, Department of Surgery, M256 Starling Loving Hall, 320W 10th Avenue, Columbus, OH 43210, USA., Roch A; Indiana University School of Medicine, Department of Surgery, 545 Barnhill Drive EH 519, Indianapolis, IN 46202, USA., Oliva E; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Smith AC; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Zhang Q; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA., Fisher WE; Baylor College of Medicine, Michael E. DeBakey Department of Surgery, One Baylor Plaza Suite 404D, Houston, TX 77030, USA. Electronic address: wfisher@bcm.edu.
Jazyk:	angličtina
Zdroj:	HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2018 Jun; Vol. 20 (6), pp. 514-520. Date of Electronic Publication: 2018 Feb 23.
DOI:	10.1016/j.hpb.2017.11.008
Abstrakt:	Background: Although used as criterion for early drain removal, postoperative day (POD) 1 drain fluid amylase (DFA) ≤ 5000 U/L has low negative predictive value for clinically relevant postoperative pancreatic fistula (CR-POPF). It was hypothesized that POD3 DFA ≤ 350 could provide further information to guide early drain removal. Methods: Data from a pancreas surgery consortium database for pancreatoduodenectomy and distal pancreatectomy patients were analyzed retrospectively. Those patients without drains or POD 1 and 3 DFA data were excluded. Patients with POD1 DFA ≤ 5000 were divided into groups based on POD3 DFA: Group A (≤350) and Group B (>350). Operative characteristics and 60-day outcomes were compared using chi-square test. Results: Among 687 patients in the database, all data were available for 380. Fifty-five (14.5%) had a POD1 DFA > 5000. Among 325 with POD1 DFA ≤ 5000, 254 (78.2%) were in Group A and 71 (21.8%) in Group B. Complications (35 (49.3%) vs 87 (34.4%); p = 0.021) and CR-POPF (13 (18.3%) vs 10 (3.9%); p < 0.001) were more frequent in Group B. Conclusions: In patients with POD1 DFA ≤ 5000, POD3 DFA ≤ 350 may be a practical test to guide safe early drain removal. Further prospective testing may be useful. (Copyright © 2018 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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