Impact of Highest Drain Fluid Amylase Levels on Surgical Outcomes and Postoperative Interventions in Patients Undergoing Pancreaticoduodenectomy

Chang Gung Memorial Hospital600 enrolled

Overview

This study investigated the impact of highest drain fluid amylase (DFA) level on postoperative pancreatic fistula (POPF) severity and outcomes of patients undergoing pancreaticoduodenectomy (PD) with POPF. Patient demographics of biochemical POPF and clinically relevant POPF (CR-POPF) were compared. Predictive factors were assessed using binary logistic regression. Receiver operating characteristic curve analysis was performed to determine the optimal cutoff value of highest DFA (beyond 3 days post-PD). The investigators compared length of hospital stay, surgical mortality rates, and need for postoperative interventions by highest DFA level.

Study Type

OBSERVATIONAL

Enrollment

600

Conditions

Pancreas; Fistula

Eligibility

Sex: ALLMin age: 20 Years

Medical Language ↔ Plain English

Inclusion Criteria: * underwent PD from October 2010 to September 2018 in our institution Exclusion Criteria: * younger than 20 years of age * clinical information was unavailable due to private or legal issues * receiving PD without pancreaticojejunostomy

Outcomes

Primary Outcomes

postoperative pancreatic fistula

fluid output of any measureable volume via an operatively placed drain with amylase activity greater than 3 times the upper normal serum value

Time frame: through study completion, an average of 2 month

Secondary Outcomes

postoperative interventions

transarterial embolization, image-guided second drainage, and reoperation

Time frame: through study completion, an average of 2 month

length of hospital stay

Time frame: through study completion, an average of 2 month

30-day mortality rates

Time frame: 30 day