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Amylase concentration of drainage fluid after total gastrectomy
1Department of Surgical Oncology, National Cancer Centre Hospital, Tokyo, Japan.
Background:
Pancreatic fistula is a serious complication of total gastrectomy with splenectomy. The amylase content of drainage fluid was examined and its usefulness for predicting pancreatic complications after gastrectomy was evaluated.
Methods:
The amylase concentration of the fluid in the peripancreatic drain was determined prospectively in 102 patients who underwent total gastrectomy in 1995.
Results:
Pancreatic fistula developed in 13 patients, whose drainage fluid amylase levels on the first postoperative morning were significantly higher than those of patients without fistula formation. Among 27 patients with amylase levels exceeding 4000 units, eight later developed pancreatic fistula, while only five (7 per cent) of 68 with amylase levels below 4000 units did so. All complications were successfully managed and there were no deaths.
Conclusion:
Determination of drainage fluid amylase levels is a simple and useful method for the prediction of pancreatic fistula formation and may help to plan appropriate management.