Sequential drain amylase to guide drain removal following pancreatectomy

Nicole Villafane-Ferriol, George Van Buren, Jose E. Mendez-Reyes, Amy L. McElhany, Nader N. Massarweh, Eric J. Silberfein, Cary Hsu, Hop S. Tran Cao, Carl Schmidt, Nicholas Zyromski, Mary E. Dillhoff, Alexandra Roch, Evelyn Oliva, Alexander C. Smith, Qianzi Zhang, William E. Fisher

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Although used as criterion for early drain removal, postoperative day (POD) 1 drain fluid amylase (DFA) ≤ 5000 U/L has low negative predictive value for clinically relevant postoperative pancreatic fistula (CR-POPF). It was hypothesized that POD3 DFA ≤ 350 could provide further information to guide early drain removal. Methods: Data from a pancreas surgery consortium database for pancreatoduodenectomy and distal pancreatectomy patients were analyzed retrospectively. Those patients without drains or POD 1 and 3 DFA data were excluded. Patients with POD1 DFA ≤ 5000 were divided into groups based on POD3 DFA: Group A (≤350) and Group B (>350). Operative characteristics and 60-day outcomes were compared using chi-square test. Results: Among 687 patients in the database, all data were available for 380. Fifty-five (14.5%) had a POD1 DFA > 5000. Among 325 with POD1 DFA ≤ 5000, 254 (78.2%) were in Group A and 71 (21.8%) in Group B. Complications (35 (49.3%) vs 87 (34.4%); p = 0.021) and CR-POPF (13 (18.3%) vs 10 (3.9%); p < 0.001) were more frequent in Group B. Conclusions: In patients with POD1 DFA ≤ 5000, POD3 DFA ≤ 350 may be a practical test to guide safe early drain removal. Further prospective testing may be useful.

Original languageEnglish (US)
JournalHPB
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Pancreatectomy
Amylases
Pancreatic Fistula
Databases
Pancreaticoduodenectomy
Chi-Square Distribution
Pancreas

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Villafane-Ferriol, N., Van Buren, G., Mendez-Reyes, J. E., McElhany, A. L., Massarweh, N. N., Silberfein, E. J., ... Fisher, W. E. (Accepted/In press). Sequential drain amylase to guide drain removal following pancreatectomy. HPB. https://doi.org/10.1016/j.hpb.2017.11.008

Sequential drain amylase to guide drain removal following pancreatectomy. / Villafane-Ferriol, Nicole; Van Buren, George; Mendez-Reyes, Jose E.; McElhany, Amy L.; Massarweh, Nader N.; Silberfein, Eric J.; Hsu, Cary; Tran Cao, Hop S.; Schmidt, Carl; Zyromski, Nicholas; Dillhoff, Mary E.; Roch, Alexandra; Oliva, Evelyn; Smith, Alexander C.; Zhang, Qianzi; Fisher, William E.

In: HPB, 01.01.2018.

Research output: Contribution to journalArticle

Villafane-Ferriol, N, Van Buren, G, Mendez-Reyes, JE, McElhany, AL, Massarweh, NN, Silberfein, EJ, Hsu, C, Tran Cao, HS, Schmidt, C, Zyromski, N, Dillhoff, ME, Roch, A, Oliva, E, Smith, AC, Zhang, Q & Fisher, WE 2018, 'Sequential drain amylase to guide drain removal following pancreatectomy', HPB. https://doi.org/10.1016/j.hpb.2017.11.008
Villafane-Ferriol N, Van Buren G, Mendez-Reyes JE, McElhany AL, Massarweh NN, Silberfein EJ et al. Sequential drain amylase to guide drain removal following pancreatectomy. HPB. 2018 Jan 1. https://doi.org/10.1016/j.hpb.2017.11.008
Villafane-Ferriol, Nicole ; Van Buren, George ; Mendez-Reyes, Jose E. ; McElhany, Amy L. ; Massarweh, Nader N. ; Silberfein, Eric J. ; Hsu, Cary ; Tran Cao, Hop S. ; Schmidt, Carl ; Zyromski, Nicholas ; Dillhoff, Mary E. ; Roch, Alexandra ; Oliva, Evelyn ; Smith, Alexander C. ; Zhang, Qianzi ; Fisher, William E. / Sequential drain amylase to guide drain removal following pancreatectomy. In: HPB. 2018.
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abstract = "Background: Although used as criterion for early drain removal, postoperative day (POD) 1 drain fluid amylase (DFA) ≤ 5000 U/L has low negative predictive value for clinically relevant postoperative pancreatic fistula (CR-POPF). It was hypothesized that POD3 DFA ≤ 350 could provide further information to guide early drain removal. Methods: Data from a pancreas surgery consortium database for pancreatoduodenectomy and distal pancreatectomy patients were analyzed retrospectively. Those patients without drains or POD 1 and 3 DFA data were excluded. Patients with POD1 DFA ≤ 5000 were divided into groups based on POD3 DFA: Group A (≤350) and Group B (>350). Operative characteristics and 60-day outcomes were compared using chi-square test. Results: Among 687 patients in the database, all data were available for 380. Fifty-five (14.5{\%}) had a POD1 DFA > 5000. Among 325 with POD1 DFA ≤ 5000, 254 (78.2{\%}) were in Group A and 71 (21.8{\%}) in Group B. Complications (35 (49.3{\%}) vs 87 (34.4{\%}); p = 0.021) and CR-POPF (13 (18.3{\%}) vs 10 (3.9{\%}); p < 0.001) were more frequent in Group B. Conclusions: In patients with POD1 DFA ≤ 5000, POD3 DFA ≤ 350 may be a practical test to guide safe early drain removal. Further prospective testing may be useful.",
author = "Nicole Villafane-Ferriol and {Van Buren}, George and Mendez-Reyes, {Jose E.} and McElhany, {Amy L.} and Massarweh, {Nader N.} and Silberfein, {Eric J.} and Cary Hsu and {Tran Cao}, {Hop S.} and Carl Schmidt and Nicholas Zyromski and Dillhoff, {Mary E.} and Alexandra Roch and Evelyn Oliva and Smith, {Alexander C.} and Qianzi Zhang and Fisher, {William E.}",
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AU - Villafane-Ferriol, Nicole

AU - Van Buren, George

AU - Mendez-Reyes, Jose E.

AU - McElhany, Amy L.

AU - Massarweh, Nader N.

AU - Silberfein, Eric J.

AU - Hsu, Cary

AU - Tran Cao, Hop S.

AU - Schmidt, Carl

AU - Zyromski, Nicholas

AU - Dillhoff, Mary E.

AU - Roch, Alexandra

AU - Oliva, Evelyn

AU - Smith, Alexander C.

AU - Zhang, Qianzi

AU - Fisher, William E.

PY - 2018/1/1

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N2 - Background: Although used as criterion for early drain removal, postoperative day (POD) 1 drain fluid amylase (DFA) ≤ 5000 U/L has low negative predictive value for clinically relevant postoperative pancreatic fistula (CR-POPF). It was hypothesized that POD3 DFA ≤ 350 could provide further information to guide early drain removal. Methods: Data from a pancreas surgery consortium database for pancreatoduodenectomy and distal pancreatectomy patients were analyzed retrospectively. Those patients without drains or POD 1 and 3 DFA data were excluded. Patients with POD1 DFA ≤ 5000 were divided into groups based on POD3 DFA: Group A (≤350) and Group B (>350). Operative characteristics and 60-day outcomes were compared using chi-square test. Results: Among 687 patients in the database, all data were available for 380. Fifty-five (14.5%) had a POD1 DFA > 5000. Among 325 with POD1 DFA ≤ 5000, 254 (78.2%) were in Group A and 71 (21.8%) in Group B. Complications (35 (49.3%) vs 87 (34.4%); p = 0.021) and CR-POPF (13 (18.3%) vs 10 (3.9%); p < 0.001) were more frequent in Group B. Conclusions: In patients with POD1 DFA ≤ 5000, POD3 DFA ≤ 350 may be a practical test to guide safe early drain removal. Further prospective testing may be useful.

AB - Background: Although used as criterion for early drain removal, postoperative day (POD) 1 drain fluid amylase (DFA) ≤ 5000 U/L has low negative predictive value for clinically relevant postoperative pancreatic fistula (CR-POPF). It was hypothesized that POD3 DFA ≤ 350 could provide further information to guide early drain removal. Methods: Data from a pancreas surgery consortium database for pancreatoduodenectomy and distal pancreatectomy patients were analyzed retrospectively. Those patients without drains or POD 1 and 3 DFA data were excluded. Patients with POD1 DFA ≤ 5000 were divided into groups based on POD3 DFA: Group A (≤350) and Group B (>350). Operative characteristics and 60-day outcomes were compared using chi-square test. Results: Among 687 patients in the database, all data were available for 380. Fifty-five (14.5%) had a POD1 DFA > 5000. Among 325 with POD1 DFA ≤ 5000, 254 (78.2%) were in Group A and 71 (21.8%) in Group B. Complications (35 (49.3%) vs 87 (34.4%); p = 0.021) and CR-POPF (13 (18.3%) vs 10 (3.9%); p < 0.001) were more frequent in Group B. Conclusions: In patients with POD1 DFA ≤ 5000, POD3 DFA ≤ 350 may be a practical test to guide safe early drain removal. Further prospective testing may be useful.

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