Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN study
Objective:. To evaluate the diagnostic accuracy of drain fluid lipase as an early predictor of postoperative pancreatic fistula and establish the most appropriate day for their measure. Background:. Clinically relevant postoperative pancreatic fistula remains a potentially life-threatening complicat...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2024-09-01
|
| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000492 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832589690166837248 |
|---|---|
| author | Béranger Doussot, MD Alexandre Doussot, MD, PhD Ahmet Ayav, MD, PhD Nicolas Santucci, MD Sophie Deguelte, MD Amadou Khalilou Sow, MD Mehdi El Amrani, MD, PhD Laurence Duvillard, MD, PhD Guillaume Piessen, MD, PhD Edouard Girard, MD, PhD Jean-Yves Mabrut, MD, PhD Jonathan Garnier, MD, PhD Pablo Ortega-Deballon, MD, PhD Isabelle Fournel, MD, PhD Olivier Facy, MD, PhD |
| author_facet | Béranger Doussot, MD Alexandre Doussot, MD, PhD Ahmet Ayav, MD, PhD Nicolas Santucci, MD Sophie Deguelte, MD Amadou Khalilou Sow, MD Mehdi El Amrani, MD, PhD Laurence Duvillard, MD, PhD Guillaume Piessen, MD, PhD Edouard Girard, MD, PhD Jean-Yves Mabrut, MD, PhD Jonathan Garnier, MD, PhD Pablo Ortega-Deballon, MD, PhD Isabelle Fournel, MD, PhD Olivier Facy, MD, PhD |
| author_sort | Béranger Doussot, MD |
| collection | DOAJ |
| description | Objective:. To evaluate the diagnostic accuracy of drain fluid lipase as an early predictor of postoperative pancreatic fistula and establish the most appropriate day for their measure.
Background:. Clinically relevant postoperative pancreatic fistula remains a potentially life-threatening complication after pancreatic surgery. Early detection strategies remain key to reduce both the incidence and the burden of pancreatic fistula.
Methods:. The LIPAse DRAIN (LIPADRAIN) study is a multicenter, prospective diagnostic study conducted in 7 tertiary university hospitals. Drain fluid values to detect clinically relevant postoperative pancreatic fistula from postoperative day 1 to postoperative day 6 were evaluated using receiver operating characteristic curve analysis. A biomarker was considered to be relevant for clinical use if its area under the curve (AUC) was greater than 0.75.
Results:. Of the 625 patients included in the analysis, clinically relevant postoperative pancreatic fistula occurred in 203 (32%) patients. On postoperative days 3 and 4, drain fluid lipase was a reliable biomarker to detect clinically relevant postoperative pancreatic fistula (AUC: 0.761; 95% confidence interval [CI]: 0.761–0.799 and AUC: 0.784; 95% CI: 0.743–0.821, respectively). On postoperative day 3, with a threshold of 299 units/L, drain fluid lipase yielded a negative predictive value of 51%, sensitivity of 78%, and specificity of 63% for the detection of clinically relevant postoperative pancreatic fistula.
Conclusions:. In this multicenter prospective study, drain fluid lipase is a reliable biomarker at postoperative days 3 and 4 for the diagnosis of clinically relevant postoperative pancreatic fistula after pancreatic surgery and should be systematically measured on postoperative day 3. |
| format | Article |
| id | doaj-art-3fc5b14c1af04c3f8d31ea5fcf13d616 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-3fc5b14c1af04c3f8d31ea5fcf13d6162025-01-24T09:18:49ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-09-0153e49210.1097/AS9.0000000000000492202409000-00040Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN studyBéranger Doussot, MD0Alexandre Doussot, MD, PhD1Ahmet Ayav, MD, PhD2Nicolas Santucci, MD3Sophie Deguelte, MD4Amadou Khalilou Sow, MD5Mehdi El Amrani, MD, PhD6Laurence Duvillard, MD, PhD7Guillaume Piessen, MD, PhD8Edouard Girard, MD, PhD9Jean-Yves Mabrut, MD, PhD10Jonathan Garnier, MD, PhD11Pablo Ortega-Deballon, MD, PhD12Isabelle Fournel, MD, PhD13Olivier Facy, MD, PhD14* From the Department of Digestive and Surgical Oncology, University Hospital Dijon, Dijon, France† Department of Digestive Surgical Oncology, Liver Transplantation Unit, CHU Besancon, Besancon, France‡ Department of Hepatobiliary, Colorectal and Digestive Surgery, University of Nancy, CHU Nancy-Brabois, Nancy, France* From the Department of Digestive and Surgical Oncology, University Hospital Dijon, Dijon, France§ Department of Endocrine, Digestive and Oncological Surgery, Robert-Debré University Hospital, Reims, France‖ INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France¶ Department of Digestive Surgery and Liver Transplantation, Claude Huriez University Hospital, Lille, France# Université de Bourgogne, INSERM Research Center U1231- PADYS team, Department of Biochemistry, University Hospital Dijon, Dijon, France†† Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille, France‡‡ Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, Grenoble, France§§ Department of Hepatobiliopancreatic Surgery and Liver Transplantation, Hospital Croix Rousse, Lyon, France‖‖ Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France.* From the Department of Digestive and Surgical Oncology, University Hospital Dijon, Dijon, France‖ INSERM, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, Dijon, France* From the Department of Digestive and Surgical Oncology, University Hospital Dijon, Dijon, FranceObjective:. To evaluate the diagnostic accuracy of drain fluid lipase as an early predictor of postoperative pancreatic fistula and establish the most appropriate day for their measure. Background:. Clinically relevant postoperative pancreatic fistula remains a potentially life-threatening complication after pancreatic surgery. Early detection strategies remain key to reduce both the incidence and the burden of pancreatic fistula. Methods:. The LIPAse DRAIN (LIPADRAIN) study is a multicenter, prospective diagnostic study conducted in 7 tertiary university hospitals. Drain fluid values to detect clinically relevant postoperative pancreatic fistula from postoperative day 1 to postoperative day 6 were evaluated using receiver operating characteristic curve analysis. A biomarker was considered to be relevant for clinical use if its area under the curve (AUC) was greater than 0.75. Results:. Of the 625 patients included in the analysis, clinically relevant postoperative pancreatic fistula occurred in 203 (32%) patients. On postoperative days 3 and 4, drain fluid lipase was a reliable biomarker to detect clinically relevant postoperative pancreatic fistula (AUC: 0.761; 95% confidence interval [CI]: 0.761–0.799 and AUC: 0.784; 95% CI: 0.743–0.821, respectively). On postoperative day 3, with a threshold of 299 units/L, drain fluid lipase yielded a negative predictive value of 51%, sensitivity of 78%, and specificity of 63% for the detection of clinically relevant postoperative pancreatic fistula. Conclusions:. In this multicenter prospective study, drain fluid lipase is a reliable biomarker at postoperative days 3 and 4 for the diagnosis of clinically relevant postoperative pancreatic fistula after pancreatic surgery and should be systematically measured on postoperative day 3.http://journals.lww.com/10.1097/AS9.0000000000000492 |
| spellingShingle | Béranger Doussot, MD Alexandre Doussot, MD, PhD Ahmet Ayav, MD, PhD Nicolas Santucci, MD Sophie Deguelte, MD Amadou Khalilou Sow, MD Mehdi El Amrani, MD, PhD Laurence Duvillard, MD, PhD Guillaume Piessen, MD, PhD Edouard Girard, MD, PhD Jean-Yves Mabrut, MD, PhD Jonathan Garnier, MD, PhD Pablo Ortega-Deballon, MD, PhD Isabelle Fournel, MD, PhD Olivier Facy, MD, PhD Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN study Annals of Surgery Open |
| title | Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN study |
| title_full | Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN study |
| title_fullStr | Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN study |
| title_full_unstemmed | Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN study |
| title_short | Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN study |
| title_sort | diagnostic accuracy of lipase as early predictor of postoperative pancreatic fistula results from the lipadrain study |
| url | http://journals.lww.com/10.1097/AS9.0000000000000492 |
| work_keys_str_mv | AT berangerdoussotmd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT alexandredoussotmdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT ahmetayavmdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT nicolassantuccimd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT sophiedegueltemd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT amadoukhalilousowmd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT mehdielamranimdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT laurenceduvillardmdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT guillaumepiessenmdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT edouardgirardmdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT jeanyvesmabrutmdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT jonathangarniermdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT pabloortegadeballonmdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT isabellefournelmdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy AT olivierfacymdphd diagnosticaccuracyoflipaseasearlypredictorofpostoperativepancreaticfistularesultsfromthelipadrainstudy |