To Study the Biochemical Markers for the Prediction of Fistula Formation after Pancreatic Resection Surgery in the Post Operative Period

Biochemical Markers for the Prediction of Fistula Formation

  • SA Mir MD, Pathology, SKIIMS, Soura, Srinagar, Jammu and Kashmir, India
  • S. Akhter PG Scholar, Department of Surgery, Govt. Medical College, Karan Nagar, Srinagar, India
  • S. S. Ahmad Associate Professor, Department of Surgery, World College of Medical Sciences and Hospital, Gurwar, Jhajjar, Haryana, India
  • S. H. Altaf Medical Officer, Department of Surgery, World College of Medical Sciences and Hospital, Gurwar, Jhajjar, Haryana, India
  • J. Ahmad Associate Professor, Department of Surgery, Govt. Medical College, Karan Nagar, Srinagar, India
  • N. Jehan Associate Professor, Department of Surgery, Govt. Medical College, Karan Nagar, Srinagar, India
  • Asmaa Associate Professor, Department of Surgery, Govt. Medical College, Karan Nagar, Srinagar, India
Keywords: Pancreatic fistula, Pancreaticoduodenectomy


Background: To study and assess the potential laboratory biomarkers for foreseeing postoperative pancreatic fistula (POPF) after pancreatic resection medical procedures. Subjects and Methods: 64 patients were studied from Jan 2008 to Dec 2018. All patients undergoing Pancreatic resection surgeries like Pancreaticoduodenectomy (PD), distal Pancreatectomy (DP) for tumors of the periampullary region, Pancreatic body or chronic pancreatitis Clinical data of the patients, surgical approach, pancreatic parenchymal tissue consistency, histopathology of the specimen, white blood cell count and blood amylase levels tube Drain fluid amylase were recorded and analyzed. Correlations between these parameters and postoperative pancreatic fistula (POPF) were assessed. Results : 22 out of the 64 (34.37%) patients developed POPF. The fistula was graded according to the ISPG classification. It was Grade An of every 10 (45.45%) patients, grade B in 8 (36.36%), and grade C in 4 (18.18%),.On univariate and multivariate strategic relapse investigations, higher amylase levels in the stomach waste liquid on a postoperative day (POD)1 and higher serum amylase levels on POD4 indicated a critical relationship with fistula arrangement in the post-operation period (POPF) (P < 0.05). On ROC (recipient working trademark bend) examination, amylase cut-off degree of 2270.67 U/L in the stomach waste liquid was related with a 76.6% affectability and 82% particularity [area under the bend (AUC): 0.844; P = 0.009]. A cut-off serum amylase level of 53.2 U/L was related with a 74.6% affectability and 72.9% explicitness (AUC: 0.784; P = 0.05). Conclusion: Post-operative channel liquid amylase levels on day 1 and serum amylase level on day 4 speak to interesting biomarkers related to POPF improvement after the pancreatic medical procedure.


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