ArticleBMC surgery2023
Drain fluid and serum amylase concentration ratio is the most reliable indicator for predicting postoperative pancreatic fistula after distal pancreatectomy.
Article in BMC surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 14 citations in OpenAlex.
- Clinical Evaluation of Postoperative Day 3 Serum Lipase in Relation to Clinically Relevant Pancreatic Fistula After Distal Pancreatectomy: A Retrospective Cohort Study.Biomedicines · 2026Article
- Early Detection of Anastomotic Leak via the Drain/Serum Amylase Ratio in Patients Undergoing Colorectal Surgery, Particularly in Ileal Anastomosis.Yonsei medical journal · 2025Article
- Article
- Risk assessment for pancreatic fistula by intraoperative image analysis of laparoscopic and robotic gastrectomy.Surgical endoscopy · 2024Article
- Letter to Editor Regarding Article "Development of a Nomogram to Predict Clinically Relevant Postoperative Pancreatic Fistula After Pancreaticoduodenectomy on the Basis of Visceral Fat Area and Magnetic Resonance Imaging".Annals of surgical oncology · 2024Article
- Response to: Comment on "Risk Models for Developing Pancreatic Fistula After Pancreatoduodenectomy: Validation in a Nationwide Prospective Cohort".Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Letter to Editor Regarding Article "ASO Visual Abstract: Development of a Nomogram to Predict Clinically Relevant Postoperative Pancreatic Fistula After Pancreaticoduodenectomy Based on Visceral Fat Area and Magnetic Resonance Imaging".Annals of surgical oncology · 2024Article
- Comment on Article "Postoperative Serum Hyperamylasemia Adds Sequential Value to the Fistula Risk Score in Predicting Pancreatic Fistula After Pancreatoduodenectomy".Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Comment on Article "Risk Models for Developing Pancreatic Fistula After Pancreatoduodenectomy: Validation in a Nationwide Prospective Cohort".Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
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Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative pancreatic fistula (POPF) is a major complication of pancreatic surgery. Drain fluid amylase concentration (DAC) is considered a predictive indicator of POPF. However, other indicators related to postoperative drain fluid amylase status exist, and the most reliable indicator for predicting POPF remains unclear. The object of this study is to identify the single most accurate indicator related to drain fluid amylase status of POPF after distal pancreatectomy (DP).
methodsThis single-institution retrospective study included 122 patients who underwent DP. The study was conducted between 2010 and 2022 at Gifu University Hospital. We statistically analyzed DAC, drain fluid amylase amount (DAA) calculated by multiplying DAC and daily drainage volume, and drain and serum amylase concentration ratio (DSACR) to assess the correlation with POPF.
resultsBased on the definition and grading of the International Study Group of Pancreatic Fistula, 24.6 (%) of the 122 patients had Grades B and C POPF. The result of the receiver operating characteristic (ROC) curve for predicting POPF after DP, DSACR had the highest area under curve(AUC) value among DAC, DAA, and DSACR both POD1 and POD3. The cutoff value of DSACR on POD1 was 17 (AUC 0.69, sensitivity 80.0%, specificity 58.2%, and accuracy 63.6%). The cutoff value of DSACR on POD3 was 22 (AUC 0.77, sensitivity 77.7%, specificity 73.3%, and accuracy 73.6%). Overall, DSACR on POD3 had the highest AUC value. Furthermore, a multivariate logistic regression analysis revealed that pancreatic texture (soft; odds ratio [OR] 9.22; 95% confidence interval [CI] 2.22-44.19; p < 0.01) and DSACR on POD3 (> 22; OR 8.76; 95% CI 2.78-31.59; p < 0.001) were independently associated with POPF after DP.
conclusionsDSACR is the most reliable indicator of drain fluid amylase status for predicting POPF after DP.
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