Volume 104, Issue 3 pp. 274-277
Research Article

Is routine measurement of amylase concentration in drainage fluid necessary after total gastrectomy for gastric cancer?

Yoshito Tomimaru MD

Yoshito Tomimaru MD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Department of Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan

Search for more papers by this author
Isao Miyashiro MD, PhD

Corresponding Author

Isao Miyashiro MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka 537-8511, Japan. Fax: +81-6-6981-8055.Search for more papers by this author
Kentaro Kishi MD, PhD

Kentaro Kishi MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Search for more papers by this author
Masaaki Motoori MD, PhD

Masaaki Motoori MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Search for more papers by this author
Masahiko Yano MD, PhD

Masahiko Yano MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Search for more papers by this author
Tatsushi Shingai MD, PhD

Tatsushi Shingai MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Search for more papers by this author
Shingo Noura MD, PhD

Shingo Noura MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Search for more papers by this author
Masayuki Ohue MD, PhD

Masayuki Ohue MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Search for more papers by this author
Hiroaki Ohigashi MD, PhD

Hiroaki Ohigashi MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Search for more papers by this author
Osamu Ishikawa MD, PhD

Osamu Ishikawa MD, PhD

Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Search for more papers by this author
First published: 14 April 2011
Citations: 12

Abstract

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.

Methods

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.

Results

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.

Conclusions

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.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.