Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 244] Clinical Implication of Intraoperative Fluid Amylase during Pancreaticoduodenectomy
Dr Rohit DHAWAN 1, Dr Sachin ARORA 2
1 Surgical Gastroeterology /HPB, Emc Hospital Amritsar Punjab India , INDIA, 2 Surgical Gastroenetrology /HPB, Graphic Era Hospital Dehradhun India , INDIA
Background : Postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is a major morbidity and mortality. Early diagnosis and treatment of POPF is mandatory to improve outcomes .The aim of this pilot study was to determine if intraoperative fluid amylase (IFA) values correlate with DFA1 and POPF.
Methods : In patients undergoing PD from February 2022 to December 2023 , intraoperative samples of intra-abdominal fluid adjacent to the pancreatic anastomosis were taken and sent for fluid amylase measurement prior to abdominal closure. Data regarding patient demographics, postoperative DFA values, complications, and mortality were prospectively collected.
Results : Data were obtained for 25 patients . Postoperative complications occurred in 13 (52 %) patients (five Clavien grade ≥ 3). There were eight POPFs and 2 patients died (sepsis). There was a significant correlation between IFA and DFA1 ( p < 0.001) and DFA3 (p < 0.001), and the median IFA was higher in patients with POPF than patients without (1,232.5 vs. 122; p = 0.0003). IFA > 260 U/L predicted POPF with sensitivity, specificity, positive and negative predictive values of 88.0%, 75.0%, 39.0%, and 97.0%, respectively. The incidence of POPF was 43.0% in high-risk (high FRS/ IFA) and 0% in low risk patients (low FRS/IFA).
Conclusions : IFA correlated with POPF and may be a useful adjunct to clinical risk scores to stratify patients during PD. Larger, prospective studies are needed to determine whether IFA has clinical utility.
Methods : In patients undergoing PD from February 2022 to December 2023 , intraoperative samples of intra-abdominal fluid adjacent to the pancreatic anastomosis were taken and sent for fluid amylase measurement prior to abdominal closure. Data regarding patient demographics, postoperative DFA values, complications, and mortality were prospectively collected.
Results : Data were obtained for 25 patients . Postoperative complications occurred in 13 (52 %) patients (five Clavien grade ≥ 3). There were eight POPFs and 2 patients died (sepsis). There was a significant correlation between IFA and DFA1 ( p < 0.001) and DFA3 (p < 0.001), and the median IFA was higher in patients with POPF than patients without (1,232.5 vs. 122; p = 0.0003). IFA > 260 U/L predicted POPF with sensitivity, specificity, positive and negative predictive values of 88.0%, 75.0%, 39.0%, and 97.0%, respectively. The incidence of POPF was 43.0% in high-risk (high FRS/ IFA) and 0% in low risk patients (low FRS/IFA).
Conclusions : IFA correlated with POPF and may be a useful adjunct to clinical risk scores to stratify patients during PD. Larger, prospective studies are needed to determine whether IFA has clinical utility.
SESSION
E-poster
E-Session 03/21 ALL DAY