Evaluation of the Value of Intraoperative Peri-Pancreatic Fluid Amylase Concentration in Predicting a Postoperative Pancreatic Fistula After Pancreaticoduodenectomy

Background: Postoperative pancreatic fistula (POPF) is a common complication after pancreaticoduodenectomy (PD) and is a cause of significant morbidity and mortality. This study aimed to assess the predictive value of the amylase concentration of fluid accumulating in the peri-pancreatic region intr...

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Published in:Curēus (Palo Alto, CA) CA), 2023-08, Vol.15 (8), p.e44475-e44475
Main Authors: Balaga, Sravanti, Vutukuru, Venkatarami Reddy, Gavini, Sivaramakrishna, Chandrakasan, Chandramaliteeswaran, Musunuru, Brahmeswara Rao
Format: Article
Language:English
Subjects:
Abdomen
Body mass index
Cancer
Comorbidity
Demographics
Fistula
General Surgery
Ostomy
Pancreaticoduodenectomy
Patients
Software
Statistical analysis
Surgery
Tumors
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container_issue 8
container_start_page e44475
container_title Curēus (Palo Alto, CA)
container_volume 15
creator Balaga, Sravanti
Vutukuru, Venkatarami Reddy
Gavini, Sivaramakrishna
Chandrakasan, Chandramaliteeswaran
Musunuru, Brahmeswara Rao
description Background: Postoperative pancreatic fistula (POPF) is a common complication after pancreaticoduodenectomy (PD) and is a cause of significant morbidity and mortality. This study aimed to assess the predictive value of the amylase concentration of fluid accumulating in the peri-pancreatic region intraoperatively or intraoperative amylase concentration (IOAC) for the development of a clinically relevant POPF after PD.Methods: All consecutive patients who underwent PD between April 2018 and May 2021 were prospectively included in the study. IOAC and postoperative day-three drain fluid amylase values were measured, and the incidence of clinically relevant POPF (CR-POPF) was noted. Receiver operating characteristic analysis was used to evaluate the predictive capacity of the IOAC for a CR-POPF.Results: The study included 64 patients. A clinically relevant POPF was seen in 12 (18.8%) patients. On ROC analysis, the area under the curve (AUC) was 0.912 (with 95% CI of 0.822-1.001, p
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This study aimed to assess the predictive value of the amylase concentration of fluid accumulating in the peri-pancreatic region intraoperatively or intraoperative amylase concentration (IOAC) for the development of a clinically relevant POPF after PD.Methods: All consecutive patients who underwent PD between April 2018 and May 2021 were prospectively included in the study. IOAC and postoperative day-three drain fluid amylase values were measured, and the incidence of clinically relevant POPF (CR-POPF) was noted. Receiver operating characteristic analysis was used to evaluate the predictive capacity of the IOAC for a CR-POPF.Results: The study included 64 patients. A clinically relevant POPF was seen in 12 (18.8%) patients. On ROC analysis, the area under the curve (AUC) was 0.912 (with 95% CI of 0.822-1.001, p&lt;0.001), which is highly significant. A cut-off IOAC value of 236 IU/L was derived, and an IOAC above this value was shown to predict the development of a CR-POPF in the postoperative period with a sensitivity of 91.7%. The highest positive predictive value (87.5%) was obtained with a cut-off of 772 IU/L.Conclusion: An IOAC is an early, simple, and sensitive predictor for the development of a clinically relevant POPF after PD and can potentially aid in managing the resulting morbidity with intraoperative and postoperative measures.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.44475</identifier><language>eng</language><publisher>Palo Alto: Cureus Inc</publisher><subject>Abdomen ; Body mass index ; Cancer ; Comorbidity ; Demographics ; Fistula ; General Surgery ; Ostomy ; Pancreaticoduodenectomy ; Patients ; Software ; Statistical analysis ; Surgery ; Tumors</subject><ispartof>Curēus (Palo Alto, CA), 2023-08, Vol.15 (8), p.e44475-e44475</ispartof><rights>Copyright © 2023, Balaga et al. This work is published under https://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2023, Balaga et al. 2023 Balaga et al.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c277t-a1c7635669e6b0631346c7236c9c2070e5e86de95d8211fd0763220c1f9acbb63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2884518947/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2884518947?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids></links><search><creatorcontrib>Balaga, Sravanti</creatorcontrib><creatorcontrib>Vutukuru, Venkatarami Reddy</creatorcontrib><creatorcontrib>Gavini, Sivaramakrishna</creatorcontrib><creatorcontrib>Chandrakasan, Chandramaliteeswaran</creatorcontrib><creatorcontrib>Musunuru, Brahmeswara Rao</creatorcontrib><title>Evaluation of the Value of Intraoperative Peri-Pancreatic Fluid Amylase Concentration in Predicting a Postoperative Pancreatic Fistula After Pancreaticoduodenectomy</title><title>Curēus (Palo Alto, CA)</title><description>Background: Postoperative pancreatic fistula (POPF) is a common complication after pancreaticoduodenectomy (PD) and is a cause of significant morbidity and mortality. This study aimed to assess the predictive value of the amylase concentration of fluid accumulating in the peri-pancreatic region intraoperatively or intraoperative amylase concentration (IOAC) for the development of a clinically relevant POPF after PD.Methods: All consecutive patients who underwent PD between April 2018 and May 2021 were prospectively included in the study. IOAC and postoperative day-three drain fluid amylase values were measured, and the incidence of clinically relevant POPF (CR-POPF) was noted. Receiver operating characteristic analysis was used to evaluate the predictive capacity of the IOAC for a CR-POPF.Results: The study included 64 patients. A clinically relevant POPF was seen in 12 (18.8%) patients. On ROC analysis, the area under the curve (AUC) was 0.912 (with 95% CI of 0.822-1.001, p&lt;0.001), which is highly significant. A cut-off IOAC value of 236 IU/L was derived, and an IOAC above this value was shown to predict the development of a CR-POPF in the postoperative period with a sensitivity of 91.7%. The highest positive predictive value (87.5%) was obtained with a cut-off of 772 IU/L.Conclusion: An IOAC is an early, simple, and sensitive predictor for the development of a clinically relevant POPF after PD and can potentially aid in managing the resulting morbidity with intraoperative and postoperative measures.</description><subject>Abdomen</subject><subject>Body mass index</subject><subject>Cancer</subject><subject>Comorbidity</subject><subject>Demographics</subject><subject>Fistula</subject><subject>General Surgery</subject><subject>Ostomy</subject><subject>Pancreaticoduodenectomy</subject><subject>Patients</subject><subject>Software</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Tumors</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkc1qGzEUhYfQQIyTXR5AkE0XnVTSaCTNqhiTtIFAvEi7FbLmTiwzI7n6Mfh98qCdiUNws5J0z9HHPZyiuCb4Voi6-W5ygBxvGWOiPitmlHBZSiLZl5P7RXEV4xZjTLCgWOBZ8Xq3133WyXqHfIfSBtCfcQDT48GloP0OwijvAa0g2HKlnQkwDgy677Nt0WI49DoCWnpnYPrwhrIOrQK01iTrXpBGKx_TCekEYmPKvUaLLkE4EXybfQsOTPLD4bI473Qf4er9nBe_7--el7_Kx6efD8vFY2moEKnUxAhe1Zw3wNeYV6Ri3AhacdOYKS3UIHkLTd1KSkjX4tFNKTaka7RZr3k1L34cubu8HqA95unVLthBh4Py2qr_FWc36sXvFcE1YxURI-HrOyH4vxliUoONBvpeO_A5KioFlbgmAo_Wm0_Wrc_BjflGl2Q1kQ2bgN-OLhN8jAG6j20IVlPv6ti7euu9-gfxJaX0</recordid><startdate>20230831</startdate><enddate>20230831</enddate><creator>Balaga, Sravanti</creator><creator>Vutukuru, Venkatarami Reddy</creator><creator>Gavini, Sivaramakrishna</creator><creator>Chandrakasan, Chandramaliteeswaran</creator><creator>Musunuru, Brahmeswara Rao</creator><general>Cureus Inc</general><general>Cureus</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230831</creationdate><title>Evaluation of the Value of Intraoperative Peri-Pancreatic Fluid Amylase Concentration in Predicting a Postoperative Pancreatic Fistula After Pancreaticoduodenectomy</title><author>Balaga, Sravanti ; 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This study aimed to assess the predictive value of the amylase concentration of fluid accumulating in the peri-pancreatic region intraoperatively or intraoperative amylase concentration (IOAC) for the development of a clinically relevant POPF after PD.Methods: All consecutive patients who underwent PD between April 2018 and May 2021 were prospectively included in the study. IOAC and postoperative day-three drain fluid amylase values were measured, and the incidence of clinically relevant POPF (CR-POPF) was noted. Receiver operating characteristic analysis was used to evaluate the predictive capacity of the IOAC for a CR-POPF.Results: The study included 64 patients. A clinically relevant POPF was seen in 12 (18.8%) patients. On ROC analysis, the area under the curve (AUC) was 0.912 (with 95% CI of 0.822-1.001, p&lt;0.001), which is highly significant. A cut-off IOAC value of 236 IU/L was derived, and an IOAC above this value was shown to predict the development of a CR-POPF in the postoperative period with a sensitivity of 91.7%. The highest positive predictive value (87.5%) was obtained with a cut-off of 772 IU/L.Conclusion: An IOAC is an early, simple, and sensitive predictor for the development of a clinically relevant POPF after PD and can potentially aid in managing the resulting morbidity with intraoperative and postoperative measures.</abstract><cop>Palo Alto</cop><pub>Cureus Inc</pub><doi>10.7759/cureus.44475</doi><oa>free_for_read</oa></addata></record>
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subjects Abdomen
Body mass index
Cancer
Comorbidity
Demographics
Fistula
General Surgery
Ostomy
Pancreaticoduodenectomy
Patients
Software
Statistical analysis
Surgery
Tumors
title Evaluation of the Value of Intraoperative Peri-Pancreatic Fluid Amylase Concentration in Predicting a Postoperative Pancreatic Fistula After Pancreaticoduodenectomy
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