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Postoperative drain amylase predicts pancreatic fistula in pancreatic surgery: A systematic review and meta-analysis

Published on Oct 1, 2015in International Journal of Surgery
· DOI :10.1016/j.ijsu.2015.07.007
Ji Yang2
Estimated H-index: 2
(Anhui Medical University),
Qiang Huang2
Estimated H-index: 2
(Anhui Medical University),
Chao Wang2
Estimated H-index: 2
(Anhui Medical University)
Abstract
Abstract Background and objectives This study to evaluate the utility of drain fluid amylase as a predictor of PF in patients undergoing pancreatic surgery based on the International Study Group of Pancreatic Fistula definitions of pancreatic fistula. Methods A comprehensive search was carried out using Pubmed (Medline), Embase, Web of science and Cochrane database for clinical trials, which studied DFA as a diagnostic marker for pancreatic fistula after pancreatic surgery. Sensitivity, specificity and the diagnostic odds ratios with 95% confidence interval were calculated for each study. Summary receiver-operating curves were conducted and the area under the curve was evaluated. Results A total of 10 studies were included. The pooled sensitivity and specificity of drain fluid amylase Day 1 for the diagnosis of postoperative pancreatic fistula were 81% and 87%, respectively (area under the curve was 0.897, diagnostic odds ratios was 16.83 and 95%CI was 12.66–22.36), the pooled sensitivity and specificity of drain fluid amylase Day 3 for the diagnosis of postoperative pancreatic fistula were 56% and 79%, respectively (area under the curve was 0.668, diagnostic odds ratios was 3.26 and 95%CI was 1.83–5.82) Conclusions The drain fluid amylase Day 1, instead of drain fluid amylase Day 3, may be a useful criterion for the early identification of postoperative pancreatic fistula, and a value of drain fluid amylase Day 1 over than 1300 U/L was a risk factor of pancreatic fistula. And the diagnostic accuracy and the proposed cut-off levels of drain fluid amylase Day 1 in predicting the postoperative pancreatic fistula will have to be validated by multicenter prospective studies.
  • References (50)
  • Citations (9)
References50
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#1Jun Yoshino (Tokyo Medical and Dental University)
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#1Mario Gruppo (UNIPD: University of Padua)H-Index: 12
#2Imerio Angriman (UNIPD: University of Padua)H-Index: 22
Last.Romeo Bardini (UNIPD: University of Padua)H-Index: 17
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#1Enio Campos Amico (UFRN: Federal University of Rio Grande do Norte)H-Index: 3
#2Ítalo Medeiros Azevedo (UFRN: Federal University of Rio Grande do Norte)H-Index: 9
Last.Samir Assi João (UFRN: Federal University of Rio Grande do Norte)H-Index: 3
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#1Yang Gao (SJTU: Shanghai Jiao Tong University)H-Index: 6
#2Yayun Zhu (SJTU: Shanghai Jiao Tong University)H-Index: 3
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