Fromm and Schwarz listed various criteria for pancreatic fistula developing after pancreatic surgery.
Different types of criteria used:
(1) volume per day of fluid with amylase > serum for several days
(2) clinical or imaging study diagnosis
(3) drainage of fluid nonfecal and nonbiliary
|
Volume Per Day and Amylase |
Duration |
Author |
|
>= 25 mL per day of amylase rich fluid |
>= 2 weeks |
Bartoli et al 1991 |
|
>= 50 mL per day amylase rich fluid |
> 2 week |
Crist 1987 |
|
>= 200 mL per day with amylase concentration > blood |
|
Bartoli et al 1991 |
|
> 50 mL/day with an amylase 3 times serum on or after POD 10 |
|
Papachristou et al 1980 |
|
amylase concentration > 4 times normal serum |
>= 3 days |
Suc 2003 |
|
>= 40 mL per day with amylase concentration 10 times plasma |
> 7 days |
Reissman 1995 |
|
> 100 mL per day of clear fluid with an amylase concentration 10 times serum |
|
Al Sharaf 1997 |
where:
• Lipase might be an alternative marker to amylase.
• The different criteria may have different perspectives. Any drainage of an amylase-rich fluid for any length of time could represent a fistula. A surgeon may be concerned more with a fistula that needs to be surgically repaired rather than one that resolves on its own.
|
Clinical or Imaging Study Diagnosis |
Duration |
Author |
|
findings at reoperation consistent with anastomotic dehiscence |
|
Grobmeyer et al 2000 |
|
radiologic evidence of leakage |
|
Reissman 1995 |
|
drain required |
> 20 days |
Marcus 1995 |
|
clinically and radiologically demonstrated |
|
Suc 2003 |
|
Drainage |
Duration |
Author |
|
nonbiliary and nonfecal material |
> 5 days |
Papachristou and Fortner 1981 |
|
bile-stained fluid causing skin erosion |
|
Papachristou et al 1980 |
|
nonbiliary and nonfecal material |
> 7 days |
Papachristou 1981 |
Specialty: Gastroenterology, Surgery, general
