Is routine measurement of amylase concentration in drainage fluid necessary after total gastrectomy for gastric cancer?
Article first published online: 14 APR 2011
Copyright © 2011 Wiley-Liss, Inc.
Journal of Surgical Oncology
Volume 104, Issue 3, pages 274–277, 1 September 2011
How to Cite
Tomimaru, Y., Miyashiro, I., Kishi, K., Motoori, M., Yano, M., Shingai, T., Noura, S., Ohue, M., Ohigashi, H. and Ishikawa, O. (2011), Is routine measurement of amylase concentration in drainage fluid necessary after total gastrectomy for gastric cancer?. J. Surg. Oncol., 104: 274–277. doi: 10.1002/jso.21938
- Issue published online: 1 AUG 2011
- Article first published online: 14 APR 2011
- Manuscript Accepted: 16 MAR 2011
- Manuscript Received: 10 AUG 2010
- astric cancer;
- total gastrectomy;
- pancreatic fistula;
Background and Objectives
Measurement of amylase level in drainage fluid (D-AMY) is often performed for detection of pancreatic fistula (PF) formation after total gastrectomy. However, PF incidence has decreased and PF formation can be judged by changes in drainage fluid properties. The aim of study is to compare the significance of drainage fluid inspection for PF formation with D-AMY measurement.
PF incidence, drainage fluid properties, and D-AMY level in drainage fluid were investigated retrospectively in 173 patients undergoing total gastrectomy for gastric cancer. The sensitivity and specificity of changes in fluid properties for PF detection were compared to D-AMY measurement.
PF incidence in patients with dark-red colored drainage fluid (16/51) was higher than in those without dark-red fluid (0/122, P < 0.0001). The sensitivity and specificity of diagnosis by fluid properties were 100% and 77.7%, respectively. PF formation also correlated with D-AMY level, with sensitivity and specificity of diagnosis by D-AMY level of 5,000 U of 100% and 82.2%, respectively. There were no differences in the above parameters between the two diagnostic methods.
Drainage fluid inspection can provide accurate diagnosis of PF formation, similar to D-AMY measurement, suggesting that routine D-AMY measurement is probably not necessary in every patient. J. Surg. Oncol. 2011; 104:274–277. © 2011 Wiley-Liss, Inc.