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Postoperative Serum Amylase Predicts Pancreatic Fistula Formation Following Pancreaticoduodenectomy

  • 2013 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Early identification of patients at risk for developing pancreatic fistula (PF) after pancreaticoduodenectomy (PD) may facilitate prevention or treatment strategies aimed at reducing its associated morbidity.

Materials and Methods

A retrospective review of 176 consecutive PD performed between 2006 and 2011 was conducted in order to analyze the association between the serum amylase on postoperative day 1 (POD1) and the development of PF.

Results

Serum amylase was recorded on POD1 in 146 of 176 PD cases (83.0 %). Twenty-seven patients (18.5 %) developed a postoperative PF: 6 type A, 19 type B, and 2 type C. Patients with a PF had a mean serum amylase on POD1 of 659 ± 581 compared to 246 ± 368 in those without a fistula (p < 0.001). On logistic regression, a serum amylase >140 U/L on POD1 was strongly associated with developing a PF (OR, 5.48; 95 % CI, 1.94–15.44). Sensitivity and specificity of a postoperative serum amylase >140 U/L was 81.5 and 55.5 %, respectively. Positive and negative predictive values were 29.3 and 93.0 %, respectively.

Conclusion

An elevated serum amylase on POD1 may be used, in addition to other prognostic factors, to help stratify risk for developing PF following PD.

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Authors and Affiliations

  1. Department of Surgery, Stanford University, 300 Pasteur Dr, H3591, Stanford, CA, 94305, USA

    Jordan M. Cloyd, Zachary J. Kastenberg, Brendan C. Visser, George A. Poultsides & Jeffrey A. Norton

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  2. Zachary J. Kastenberg
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  3. Brendan C. Visser
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Correspondence to Jeffrey A. Norton.

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Poster of distinction award at the 54th Annual Meeting of the Society for Surgery of the Alimentary Tract during Digestive Disease Week 2013

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Cloyd, J.M., Kastenberg, Z.J., Visser, B.C. et al. Postoperative Serum Amylase Predicts Pancreatic Fistula Formation Following Pancreaticoduodenectomy. J Gastrointest Surg 18, 348–353 (2014). https://doi.org/10.1007/s11605-013-2293-3

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