Table of Contents    
Original Article
 
The value of postoperative measurement of amylase in abdominal drainage fluid after pancreatic surgery
F Safi1, S Bakathir2, M Taha3, T Lange4 H El Salhat2 F Branicki1
1Department of Surgery, United Arab Emirates University.
2Department of Surgery, Tawam Hospital, Al Ain, UAE.
3Department of Internal Medicine (Division Gastroenterology), Tawam Hospital, Al Ain, UAE.
3Weimer Hospital, Germany.

Article ID: 100009IJHPDRRTB2012
doi:10.5348/ijhpd-2012-9-OA-7

Address correspondence to:
Dr. Farouk Safi
Professor Department of Surgery
Faculty of Medicine & Health Sciences, United Arab Emirates University
P.O. Box 17666, Al Ain
United Arab Emirates
Email: f.safi@uaeu.ac.ae

[HTML Full Text]   [PDF Full Text]

How to cite this article:
Safi F, Bakathir S, Taha M, Lange T, Salhat HE, Branicki F. The value of postoperative measurement of amylase in abdominal drainage fluid after pancreatic surgery. International Journal of Hepathobiliary and Pancreatic Diseases 2012;2:31–37.


Abstract
Aims: Clinical symptoms accompanied by a continuous increase of amylase concentration in abdominal drainage fluid and change in color of drainage fluid may indicate the presence of fistula or leakage. Aims: To investigate the clinical relevance and utility of post-operative (PO) monitoring of amylase and lipase estimations in the serum and abdominal drainage fluid following pancreatic surgery.
Methods: Seventy patients (37 males, 33 females) who underwent duodenum-preserving pancreatic head resection [n = 12 (GI)], pylorus preserving Whipple's procedure [n = 39 (GII)], segmental resection of the body of the pancreas [n = 4 (GIII)] and pancreas tail/body resection [n = 15] were enrolled in the study prospectively. In G I, II and III (n = 55) duct mucosa anastomosis with the remnant of distal pancreas was fashioned. The serum amylase and lipase levels and levels of amylase in drainage fluid were measured pre-operatively and from PO day 1, until removal of the drain. Only 32 patients received subcutaneous octreotide, 100 μg three times daily for five days.
Results: Elevation of serum amylase (=100 IU/l) was found in 20/52 (38%) patients following pancreatic surgery. The elevated amylase levels returned to normal within four days. Abdominal drainage fluid amylase values were found increased in 19/47 (40%) of patients. All elevated levels returned to normal by the tenth post-operative day. The color of abdominal drainage fluid was sero-sanguinous in all cases. No clinical pancreatic fistula or anastomotic leakage was evident (0/55 patients), all patients were discharged home.
Conclusions: Documentation of transient elevation of serum amylase and abdominal drainage fluid amylase levels did not appear to be of clinical significance.

Key Words: Pancreatic anastomosis, Leakage, Fluid amylase level

[HTML Full Text]   [PDF Full Text]

Author Contributions:
F Safi - Major Contribution in conception and design, Acquisition of data, Analysis and interpretation of data, Substantial contribution in drafting the article, critical revision of the article and submission, Corresponding author and final approval of the version to be published
S Bakathir - Minor contribution in Conception, and Acquisition of data, Minor contribution in drafting the article, Minor contribution in final approval of the version to be published
M Taha - Minor contribution in Conception, and Acquisition of data, Minor contribution in drafting the article, Minor contribution in final approval of the version to be published
T Lange - Major Contribution in conception and design, Acquisition of data, Analysis and interpretation of data, Minor contribution in drafting the article, Minor contribution in final approval of the version to be published
H El Salhat - Minor contribution in Conception, and Acquisition of data, Minor contribution in drafting the article, Minor contribution in final approval of the version to be published
F. Branicki - Minor contribution in Conception, and Acquisition of data, Minor contribution in drafting the article, Major contribution in final approval of the version to be published
Guarantor of submission:
The corresponding author is the guarantor of submission.
Source of support:
None
Conflict of interest:
Authors declare no conflict of interest.
Copyright:
© F Safi et al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)