• Stefano Partelli, Domenico Tamburrino, Stefano Crippa, Enrico Facci, Claudio Zardini, and Massimo Falconi.
• Department of Surgery, Ospedale Sacro Cuore Don Calabria, Negrar, Verona, Italy.
• Am. J. Surg. 2014 Oct 1;208(4):634-9.

BackgroundAmylase value in drains (AVD) is a predictor of pancreatic fistula (PF). We evaluated the accuracy of an AVD-based model.MethodsTwo hundred thirty-one patients underwent pancreatoduodenectomy with pancreaticojejunostomy (PDPJ) or pancreatoduodenectomy with duct-to-mucosa (PDDTM) and distal pancreatectomy (DP). Patients with AVD greater than 5,000 U/L on postoperative day (POD) 1 underwent AVD measurement on POD5.ResultsSensitivity and specificity of POD1 AVD greater than 5,000 in predicting PF were 71% and 90%, respectively. The sensitivity and specificity of POD5 AVD greater than 200 were 90% and 83%, respectively. AVD greater than 1,000 (for PDPJ) and 2,000 U/L (PDDTM and DP) represented the most accurate cutoffs on POD1. AVD greater than 200 (PDPJ), 300 (PDDTM), and 50 U/L (DP) represented the cutoffs with the highest sensitivity in predicting PF on POD5.ConclusionAVD-based model for predicting PF after pancreatic resection is an accurate tool, although AVD cutoffs should be evaluated for each type of operation.Copyright © 2014 Elsevier Inc. All rights reserved.

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