{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:30:59Z","timestamp":1790292659986,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,2,22]],"date-time":"2012-02-22T00:00:00Z","timestamp":1329868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early detection of pancreatic fistula (PF) may improve the outcome after pancreaticoduodenectomy, and exclusion of PF may allow earlier drain removal and accelerate recovery. The aim of the present study was to evaluate the relationship between drain fluid amylase on the first postoperative day (DFA<jats:sub>1<\/jats:sub>) and PF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>This work was designed as a prospective study and included patients undergoing pancreaticoduodenectomy in a single center. For each patient, DFA was measured on the first and fifth postoperative days, and PF was defined by drainage of amylase\u2010rich fluid on the fifth postoperative day (DFA<jats:sub>5<\/jats:sub> &gt;300 U\/l). A cut\u2010off value of DFA<jats:sub>1<\/jats:sub> was derived, which yielded sensitivity and negative predictive value of 100% for predicting a PF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 70 patients (47% male) who underwent pancreaticoduodenectomy (Whipple procedure: 37; pylorus\u2010preserving procedure: 33) between April 2009 and March 2010 were included. Nine of those patients developed a PF (grade A\u20102; B\u20105; C\u20102). There were two postoperative deaths (3%). The DFA<jats:sub>1<\/jats:sub> value significantly correlated with DFA<jats:sub>5<\/jats:sub> (Spearman rank coefficient 0.68; <jats:italic>p<\/jats:italic> &lt; 0.0001). The median DFA<jats:sub>1<\/jats:sub> of patients with a PF (6,205; range 357\u201323,391) was significantly higher than in patients without a PF (69; range 5\u20135,180; <jats:italic>p<\/jats:italic> = 0.01; unpaired <jats:italic>t<\/jats:italic> test). No patient with a PF had a DFA<jats:sub>1<\/jats:sub> \u2264350 U\/l, compared to 48\/61 patients (79%) without a PF. Using 350 U\/l as a cut\u2010off, a low DFA<jats:sub>1<\/jats:sub> excluded a PF with a sensitivity, specificity, positive and negative predictive values of 100, 79, 41, and 100%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Drain fluid amylase on the DFA<jats:sub>1<\/jats:sub> after pancreaticoduodenectomy stratifies patients according to likelihood of developing a PF.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-012-1460-0","type":"journal-article","created":{"date-parts":[[2012,2,21]],"date-time":"2012-02-21T14:48:18Z","timestamp":1329835698000},"page":"879-883","source":"Crossref","is-referenced-by-count":54,"title":["Utility of Drain Fluid Amylase Measurement on the First Postoperative Day after Pancreaticoduodenectomy"],"prefix":"10.1002","volume":"36","author":[{"given":"Robert P.","family":"Sutcliffe","sequence":"first","affiliation":[{"name":"Liver Unit Queen Elizabeth Hospital 3rd Floor, Nuffield House, Edgbaston B15 2TH Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narendra","family":"Battula","sequence":"additional","affiliation":[{"name":"Liver Unit Queen Elizabeth Hospital 3rd Floor, Nuffield House, Edgbaston B15 2TH Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Haque","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King\u2019s College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Ali","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King\u2019s College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parthi","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King\u2019s College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon W.","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King\u2019s College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Rela","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King\u2019s College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel D.","family":"Heaton","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King\u2019s College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas A.","family":"Prachalias","sequence":"additional","affiliation":[{"name":"Institute of Liver Studies King\u2019s College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,2,22]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"332","article-title":"Factors influencing morbidity and mortality in pancreaticoduodenectomy","volume":"177","author":"Gilsdorf RB","year":"1972","journal-title":"Ann Surg"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010198205000\u201000010"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000246856.03918.9a"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v11.i16.2456"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7413"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20100220\u20102"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2008.03.004"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.05.001"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000146149.17411.c5"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181e61e88"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3180caa42f"},{"key":"e_1_2_5_13_2","first-page":"553","article-title":"Pancreatic juice output and amylase level in the drainage fluid after pancreatoduodenectomy in relation to leakage","volume":"49","author":"Hashimoto N","year":"2002","journal-title":"Hepatogastroenterology"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-012-1460-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-012-1460-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-012-1460-0","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T23:10:10Z","timestamp":1704928210000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-012-1460-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,22]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,4]]}},"alternative-id":["10.1007\/s00268-012-1460-0"],"URL":"https:\/\/doi.org\/10.1007\/s00268-012-1460-0","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,22]]}}}