کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4285746 1611972 2015 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Can early serum lipase measurement be routinely implemented to rule out clinically significant pancreatic fistula after pancreaticoduodenectomy?
ترجمه فارسی عنوان
آیا می توان به زودی اندازه گیری اندازه گیری لیپاز سرم به منظور جلوگیری از فیستول پانکراس قابل توجه بالینی پس از پانکراس دیویدونوکتومی انجام شد؟
کلمات کلیدی
پانکراس دیودوژنکتومی، عوارض بعد از عمل، فیستول پانکراس، لیپاز سرم
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی عمل جراحی
چکیده انگلیسی

IntroductionPostoperative pancreatic fistula (POPF) is the most significant cause of morbidity and mortality after pancreaticoduodenectomy (PD). We evaluated the role of postoperative serum lipase concentration in ruling out POPF in the immediate post-operative period.Materials and methodsWe retrospectively analysed 98 consecutive PD performed between January 2009 and December 2014, investigating the correlation between postoperative day 1 (POD1) serum lipase concentration and POPF development.Results29 patients (29.5%) developed POPF [grade A, 17 (17.3%); grade B, 8 (8.1%); grade C, 4 (4%)]. A receiver operating characteristic (ROC) analysis was conducted to determine the threshold value of POD1 serum lipase associated with clinically significant POPF (AUC = 0.76, 95% CI 0.64–0.86, P = 0.01). Such threshold was ≤44.5 U/L and its sensitivity and specificity were 92% and 66%, respectively. The positive and negative predictive values (PPV, NPV) were 31% and 98%, respectively.ConclusionEarly routinely measurement of serum lipase proved to be helpful in ruling out clinically relevant POPF (CR-POPF). In our cohort, a POD1 cut-off of ≤44.5 U/L allowed early and accurate identification of patients with low probability to develop clinically significant POPF, who can eventually be selected for enhanced post-operative recovery with significant clinical and economic benefits.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: International Journal of Surgery - Volume 21, Supplement 1, September 2015, Pages S50–S54
نویسندگان
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