Why the study?
Clinically relevant postoperative pancreatic fistula is a major morbidity after pancreatico-duodenectomy, but there is no clear consensus regarding the ideal predictor among fistula risk score and postoperative drain amylase levels.
Does postoperative day 3 drain amylase level predict clinically relevant postoperative pancreatic fistula better than fistula risk score in patients undergoing pancreatico-duodenectomy?
Population
57 patients who underwent pancreatico-duodenectomy at one institute between 2014 and 2018
Comparison
Postoperative day 3 drain amylase level vs fistula risk score
Design
Retrospective analysis
Key result
Postoperative day 3 drain amylase ≥500 IU/l was statistically superior to moderate/high fistula risk score in predicting clinically relevant postoperative pancreatic fistula (AUC 0.868 vs 0.692, p=0.028).
Authors
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May aid early CR-POPF risk stratification after PD; hypothesis-generating and requires prospective validation.
Observational (n=57)
No
Does postoperative day 3 drain amylase level predict clinically relevant postoperative pancreatic fistula better than fistula risk score in patients undergoing pancreatico-duodenectomy?
Effect estimate: AUC difference 0.175
Absolute Event Rate: 0.868% vs 0.692%
p-value: p=0.028
Postoperative day 3 drain amylase level ≥500 IU/l is a superior predictor of clinically relevant postoperative pancreatic fistula compared to the fistula risk score following pancreatico-duodenectomy.
Gowda et al. (2019) conducted an observational in Pancreatico-duodenectomy (n=57). Postoperative day 3 drain amylase (POD3DA) ≥500 IU/l vs. Fistula risk score (FRS) moderate/high was evaluated on Prediction of clinically relevant postoperative pancreatic fistula (CR-POPF) measured by Area Under the Curve (AUC) (AUC difference 0.175, p=0.028). Postoperative day 3 drain amylase ≥500 IU/l was statistically superior to moderate/high fistula risk score in predicting clinically relevant postoperative pancreatic fistula (AUC 0.868 vs 0.692, p=0.028).
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