Ascitic fluid amylase-to-serum amylase ratio to predict pancreatic duct leaks causing ascites

Autores/as

  • Reid Wasserman Department of Internal Medicine, Virginia Tech Carilion Clinic, Roanoke, Virginia, USA. https://orcid.org/0000-0003-4211-2046
  • Ahmed Ali Al Qaffas Department of Health Analytics Research, Virginia Tech Carilion Clinic, Roanoke, Virginia, USA.
  • Peter Darwin Division of Gastroenterology, Department of Internal Medicine, University of Maryland, USA. https://orcid.org/0000-0002-3049-393X
  • Klaus Mönkemüller Division of Gastroenterology, Department of Internal Medicine, Virginia Tech Carilion Clinic, Roanoke, Virginia, USA. https://orcid.org/0000-0002-1434-9348
  • Patrick Okolo Division of Gastroenterology, Department of Internal Medicine, Virginia Tech Carilion Clinic, Roanoke, Virginia, USA. https://orcid.org/0000-0003-0928-7303
  • Paul Yeaton Division of Gastroenterology, Department of Internal Medicine, Virginia Tech Carilion Clinic, Roanoke, Virginia, USA. https://orcid.org/0000-0002-1872-7377
  • Vivek Kesar Virginia Tech Carilion Clinic, Department of Internal Medicine, Division of Gastroenterology
  • Varun Kesar Division of Gastroenterology, Department of Internal Medicine, Virginia Tech Carilion Clinic, Roanoke, Virginia, USA. https://orcid.org/0000-0002-2422-0249

DOI:

https://doi.org/10.47892/rgp.2024.444.1807

Palabras clave:

Cholangiopancreatography, Endoscopic Retrograde, Pancreatic Ducts, Ascites

Resumen

Objectives: Pancreatic duct leaks can cause ascites, and fluid amylase can be used as a marker to suggest pancreatic duct leak; however, there is no reference parameter or cutoff value for diagnosis. We assessed whether a novel ratio of ascitic fluid to serum amylase can reliably predict pancreatic leaks and need for endoscopic retrograde cholangiopancreatography (ERCP). Materials and methods: Patients who had fluid amylase from ascitic fluid and serum amylase within one week of confirmed pancreatic leaks via ERCP were included along with appropriate medical and surgical controls. Results: A total of sixteen patients were included in the study group. The mean ascitic fluid amylase to serum amylase ratio in the study group was 243, and 0.3511, and 0.9406 for medical and surgical controls respectively. The cutoff ratio to predict pancreatic leaks was 6.89 with 100% sensitivity and specificity (p-value 0.0000000000001347). Conclusions: Patients with a fluid to serum amylase ratio of at least 6.89 should be considered high risk for pancreatic leak with consideration to proceed directly to ERCP.

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Citas

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Publicado

30.12.2024

Cómo citar

1.
Wasserman R, Ali Al Qaffas A, Darwin P, Mönkemüller K, Okolo P, Yeaton P, Kesar V, Kesar V. Ascitic fluid amylase-to-serum amylase ratio to predict pancreatic duct leaks causing ascites. Rev Gastroenterol Peru [nternet]. 30 de diciembre de 2024 [citado 15 de enero de 2025];44(4):329-32. isponible en: https://revistagastroperu.com/index.php/rgp/article/view/1807

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ARTÍCULOS ORIGINALES