CLINICAL SIGNIFICANCE OF AMYLASE LEVELS OF DRAINAGE FLUID IN PATIENTS WITH POSTOPERATIVE PANCREATIC FISTULA AFTER TOTAL GASTRECTOMY

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  • 胃全摘術後膵液瘻に対するドレーン排液アミラーゼ値の測定意義

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Background: Pancreatic fistula (PF) is one of serious complications after total gastrectomy (TG). Purpose: The purpose of this study is to identify the clinical significance of amylase levels of drainage fluid (D-Amy) in the patient with PF after TG. Patients and method: Between 2003 and 2005, 128 consecutive patients with gastric cancer underwent TG with splenectomy or pancreaticosplenectomy in our institution. D-Amy was measured on postoperative day (POD) 1, 3 or 4, and 7. Results: PF developed in 17 patients (13%), whose D-Amy on POD1, 3 or 4, and 7 were significantly higher than those in patients without PF. Of these 17 patients, 10 patients (59%) were able to be diagnosed as having PF with purulent drain discharge until POD7. Conclusions: D-Amy on POD 1 and POD 3 or 4 might be useful to predict the development of PF. But no clinical significance was noted in measuring D-Amy on POD 1 and POD 3 or 4, because we do not change postoperative management by D-Amy on POD 1 and POD 3 or 4 as a general rule. In the efficient postoperative management of TG for gastric cancer, it might be effective to measure D-Amy in patient without purulent drain discharge on POD 7.

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