Ji Hun Kim YUAN SHUAI 2023-02 32460 https://aurora.ajou.ac.kr/handle/2018.oak/24312 학위논문(박사)--아주대학교 일반대학원 :의학과,2023. 2 Ⅰ. INTRODUCTION 1 <br>Ⅱ. PATIENTS AND METHODS 4 <br> A. Patient Selection 5 <br> B. Surgical Technique 5 <br> C. Postoperative Management 6 <br> D. Definition of Postoperative Complications 7 <br> E. Statistical Method 8 <br>Ⅲ. RESULTS 10 <br> A. Patient Characteristics 11 <br> B. The Relationship between Patient-related Factors and POPF 14 <br> C. Derivation of the Cut-off Value of DFA1 for POPF Prediction 22 <br> D. Logistic regression verifies that DFA1 is an independent predictor of POPF 25 <br> E. Logistic Regression Verifies the Prediction of POPF by the Cut-off Value of DFA1 29 <br> F. The Relationship between Patient-related Factors and CR-POPF 33 <br>Ⅳ. DISCUSSION 39 <br>Ⅴ. CONCLUSION 46 eng The Graduate School, Ajou University 아주대학교 논문은 저작권에 의해 보호받습니다. The value of drain fluid amylase as a predictor of postoperative pancreatic fistula after pancreaticogastrostomy Thesis 아주대학교 대학원 YUAN SHUAI 일반대학원 의학과 2023-02 Doctor https://dcoll.ajou.ac.kr/dcollection/common/orgView/000000032460 Pancreaticoduodenectomy drain fluid amylase pancreatic fistula pancreaticogastrostomy relevant postoperative pancreatic fistula Background/Aim: Drain fluid amylase is commonly used as a predictor of pancreatic fistula after pancreaticoduodenectomy (PD). This study aimed to determine the ideal cut-off value of drain fluid amylase on postoperative day 1 (DFA1) for predicting pancreatic fistula after pancreaticogastrostomy (PG). <br>Patients and Methods: Prospective data of 272 consecutive patients undergoing PG between 2010 and 2020 was collected and analyzed to determine the postoperative pancreatic fistula (POPF) risk factors. <br>Results: The incidence of POPF was 143 cases (52.6%). The median DFA1 in patients with POPF was significantly higher than that of patients with NO-POPF (5483 vs 311, P &lt; 0.001). DFA1 correlated with POPF in the area under the curve (AUC) of 0.84 (P &lt; 0.001). When DFA1 was 2300U/L, Youden index was the highest, with a sensitivity of 72.7% and a specificity of 82.9%. Logistic regression analysis showed that DFA1≥2300U/L was an independent predictor of POPF (P &lt; 0.001; OR: 12.855; 95% CI: 7.019-23.544). The AUC of DFA1 and clinically relevant postoperative pancreatic fistula (CR-POPF) was 0.674 (P &lt; 0.001). <br>Conclusion: DFA1≥2300U/L can be used as an independent predictor of POPF after PG. DFA1≥3000U/L can predict the occurrence of CR-POPF, when DFA1≥3000U/L, the patients should be observed closely active for complications.