| Title: |
Postoperative Serum Hyperamylasemia Adds Sequential Value to the Fistula Risk Score in Predicting Pancreatic Fistula after Pancreatoduodenectomy. |
| Authors: |
Bannone, Elisa1 (AUTHOR) bannone.elisa@gmail.com; Marchegiani, Giovanni1 (AUTHOR) giovanni.marchegiani@aovr.veneto.it; Vollmer, Charles2 (AUTHOR) Charles.Vollmer@pennmedicine.upenn.edu; Perri, Giampaolo1 (AUTHOR) giamperri@gmail.com; Procida, Giuseppa1 (AUTHOR) giusiprocida1@gmail.com; Corvino, Gaetano1 (AUTHOR) corvino.gaetano1@gmail.com; Peressotti, Sara1 (AUTHOR) sara.peressotti@gmail.com; Vacca, Pier Giuseppe1 (AUTHOR) piero93.vacca@gmail.com; Salvia, Roberto1 (AUTHOR) roberto.salvia@univr.it; Bassi, Claudio1 (AUTHOR) claudio.bassi@univr.it |
| Source: |
Annals of Surgery. Aug2023, Vol. 278 Issue 2, pe293-e301. 9p. |
| Abstract: |
Objective: To evaluate whether postoperative serum hyperamylasemia (POH), with drain fluid amylase (DFA) and C-reactive protein (CRP), improves the Fistula Risk Score (FRS) accuracy in assessing the risk of a postoperative pancreatic fistula (POPF). Summary Background Data: The FRS predicts POPF occurrence using intraoperative predictors with good accuracy but intrinsic limits. Methods: Outcomes of patients who underwent pancreaticoduodenectomies between 2016 and 2021 were evaluated across FRS-risk zones and POH occurrence. POH consists of serum amylase activity greater than the upper limit of normal (52 U/l), persisting within the first 48 hours postoperatively (postoperative day –POD– 1 and 2). Results: Out of 905 pancreaticoduodenectomies, some FRS elements, namely soft pancreatic texture (odds ratio (OR) 11.6), pancreatic duct diameter (OR 0.80), high-risk pathologic diagnosis (OR 1.54), but not higher blood loss (OR 0.99), were associated with POH. POH was an independent predictor of POPF, which occurred in 46.8% of POH cases (P |
| Database: |
Supplemental Index |