title: Postoperative drain amylase predicts pancreatic fistula in pancreatic surgery: A systematic review and meta-analysis.
abstract: OBJECTIVE
  This study to evaluate the utility of drain fluid amylase as a predictor of PF in patients undergoing pancreatic surgery based on the International Study Group of Pancreatic Fistula definitions of pancreatic fistula.
  
  
  METHODS
  A comprehensive search was carried out using Pubmed (Medline), Embase, Web of science and Cochrane database for clinical trials, which studied DFA as a diagnostic marker for pancreatic fistula after pancreatic surgery. Sensitivity, specificity and the diagnostic odds ratios with 95% confidence interval were calculated for each study. Summary receiver-operating curves were conducted and the area under the curve was evaluated.
  
  
  RESULTS
  A total of 10 studies were included. The pooled sensitivity and specificity of drain fluid amylase Day 1 for the diagnosis of postoperative pancreatic fistula were 81% and 87%, respectively (area under the curve was 0.897, diagnostic odds ratios was 16.83 and 95%CI was 12.66-22.36), the pooled sensitivity and specificity of drain fluid amylase Day 3 for the diagnosis of postoperative pancreatic fistula were 56% and 79%, respectively (area under the curve was 0.668, diagnostic odds ratios was 3.26 and 95%CI was 1.83-5.82) CONCLUSIONS: The drain fluid amylase Day 1, instead of drain fluid amylase Day 3, may be a useful criterion for the early identification of postoperative pancreatic fistula, and a value of drain fluid amylase Day 1 over than 1300 U/L was a risk factor of pancreatic fistula. And the diagnostic accuracy and the proposed cut-off levels of drain fluid amylase Day 1 in predicting the postoperative pancreatic fistula will have to be validated by multicenter prospective studies.
authors.affiliation: Department of General Surgery, Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001, China; Hepatobiliary and Pancreatic Laboratory of Anhui Province, Hefei 230001, China. Electronic address: ahslyyyangji@163.com.
authors.forename: Ji
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of General Surgery, Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001, China; Hepatobiliary and Pancreatic Laboratory of Anhui Province, Hefei 230001, China. Electronic address: hq_sohu@sohu.com.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of General Surgery, Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001, China; Hepatobiliary and Pancreatic Laboratory of Anhui Province, Hefei 230001, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
mesh_terms: D000681:Amylases / Q000378:metabolism*; D004322:Drainage; D006801:Humans; D016017:Odds Ratio; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000175:diagnosis / Q000201:enzymology* / Q000209:etiology*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D000681:Amylases
keywords: Amylase; Meta-analysis; Pancreatectomy; Pancreatic fistula; Pancreaticoduodenectomy