Objective To investigate value of drainage fluid amylase content and other risk factors in predicting clinically relevant postoperative pancreatic fistula (CR-POPF) after laparoscopic pancreaticoduodenectomy (LPD).Methods The clinical data of 166 patients who underwent LPD in this hospital from January 2017 to December 2019 were retrospectively analyzed. The independent risk factors of CR-POPF after LPD were analyzed. And the sensitivity and specificity of drainage fluid amylase content obtained on postoperative day 1 and 3 (Abbreviated as DFA1 and DFA3, respectively) in predicting CR-POPF by receiver operating characteristic (ROC) curve.Results A total of 166 patients underwent LPD were collected in this study. The CR-POPF occurred in 16 (9.6%) patients and all of them were grade B. The DFA1 (P=0.037), DFA3 (P<0.001), and positive bacterial culture of drainage fluid after operation (P=0.020) were the independent risk factors of CR-POPF after LPD (P<0.05) by the logistic regression multivariate analysis. The area under the ROC curve of the DFA1 and DFA3 in predicting CR-POPF was 0.880 [95%CI (0.812, 0.949)] and 0.912 [95%CI (0.853, 0.971)] respectively, and the corresponding best critical value was 3 925 and 939 U/L, and the sensitivity was 100% and 100%, specificity was 64.0% and 70.7%, respectively.Conclusion For patients with DFA1>3 925 U/L, DFA3>939 U/L, and positive bacterial culture of drainage fluid after operation, preventive measures should be made to avoid CR-POPF.
CHEN Dong, WANG Ji, MA Hongqin, LIU Li, DU Yusheng, ZHAO Wenxing. Predictive value of amylase content of drainage fluid for clinically relevant postoperative pancreatic fistula after laparoscopic pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(7): 910-914. doi: 10.7507/1007-9424.202010078