Elevation of urine trypsinogen 2 is an independent risk factor for pancreatic fistula after pancreaticoduodenectomy
| Autor: | Akira Nakashima, Yoshiaki Murakami, Yasushi Hashimoto, Takeshi Sudo, Kenichiro Uemura, Taijiro Sueda, Emi Yamaoka |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Trypsinogen Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastroenterology Risk Assessment Pancreaticoduodenectomy chemistry.chemical_compound Pancreatic Fistula Young Adult Endocrinology Japan Predictive Value of Tests Risk Factors Internal medicine Internal Medicine medicine Odds Ratio Humans Trypsin Prospective Studies Risk factor Aged Pancreatic duct Aged 80 and over Univariate analysis Chi-Square Distribution Hepatology business.industry Middle Aged medicine.disease Up-Regulation medicine.anatomical_structure Logistic Models chemistry Pancreatic fistula Multivariate Analysis Hyperamylasemia Pancreatitis Female business Biomarkers |
| Zdroj: | Pancreas. 41(6) |
| ISSN: | 1536-4828 |
| Popis: | OBJECTIVES Previous reports suggested that the urine trypsinogen 2 (U-TRP2) test might be a valuable method for the diagnosis of postoperative pancreatitis after pancreatic surgery. We hypothesize that the elevation of U-TRP2 level after pancreaticoduodenectomy (PD) could be associated with the occurrence of postoperative pancreatic fistula (POPF). METHODS A total of 130 consecutive patients undergoing PD with duct-to-mucosa pancreaticogastrostomy were included. Urine samples for evaluation of U-TRP2 levels were collected prospectively. Risk factors for POPF were evaluated using univariate and multivariate analyses. RESULTS Of 130 patients, 19 developed POPF; grade A in 14 (11%), grade B in 3 (2%), and grade C in 1 (1%). Univariate analysis demonstrated that a nonobstructed main pancreatic duct, a pancreatic duct less than 3 mm, soft texture of the pancreatic gland, a PD with antrectomy, PD with hepatic resection, hyperamylasemia, and elevation of U-TRP2 levels (>50 μg/L) were significantly associated with POPF (P < 0.05). By multivariate analysis, elevation of U-TRP2 levels (odds ratio = 4.544, P = 0.029) was the only independent risk factor that correlated with POPF. CONCLUSIONS Elevation of U-TRP2 level is an independent risk factor for POPF after PD. Elevated U-TRP2 level might be the consequence of the postoperative pancreatitis, and postoperative pancreatitis may play an important role in the pathogenic mechanism of POPF after PD. |
| Databáze: | OpenAIRE |
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