BACKGROUND: Although the incidence of leaks after Roux-en-Y gastric bypass (RYGB) significantly decreased over time, their detection still remains challenging. OBJECTIVE: This study aimed to determine the usefulness of drain amylase levels to detect leaks after RYGB. METHODS: This is a population-based study which enrolled 170 individuals who underwent RYGB. Drain amylase levels were determined on the first and fourth postoperative days. Two thresholds were evaluated: three times higher than the serum levels (parameter I) and higher than 250 IU/L (parameter II). The main outcomes evaluated were perioperative morbidity, the occurrence of leaks, 30-day readmissions and reoperations, hospital stay, and mortality. RESULTS: Considering the parameter I, high drain amylase levels were significantly associated with leaks (12.5% vs 0; P<0.00001). Considering the parameter II, high drain amylase levels were significantly associated with longer hospital stay (8±5.7 vs 4.5±1.3 days; P=0.00032), 30-day reoperations (50% vs 3%; P=0.000285), and leaks (50% vs 0; P<0.00001). The parameter I presented a sensitivity of 100% and specificity of 95.9%, whereas the parameter II presented a sensitivity of 100% and a specificity of 99.4%. CONCLUSION: The determination of drain amylase levels after RYGB was a significant indicator of leaks, hospital stay, and 30-day reoperations. This finding reinforces the importance of abdominal drainage in the RYGB within this context.
BACKGROUND: Although the incidence of leaks after Roux-en-Y gastric bypass (RYGB) significantly decreased over time, their detection still remains challenging. OBJECTIVE: This study aimed to determine the usefulness of drain amylase levels to detect leaks after RYGB. METHODS: This is a population-based study which enrolled 170 individuals who underwent RYGB. Drain amylase levels were determined on the first and fourth postoperative days. Two thresholds were evaluated: three times higher than the serum levels (parameter I) and higher than 250 IU/L (parameter II). The main outcomes evaluated were perioperative morbidity, the occurrence of leaks, 30-day readmissions and reoperations, hospital stay, and mortality. RESULTS: Considering the parameter I, high drain amylase levels were significantly associated with leaks (12.5% vs 0; P<0.00001). Considering the parameter II, high drain amylase levels were significantly associated with longer hospital stay (8±5.7 vs 4.5±1.3 days; P=0.00032), 30-day reoperations (50% vs 3%; P=0.000285), and leaks (50% vs 0; P<0.00001). The parameter I presented a sensitivity of 100% and specificity of 95.9%, whereas the parameter II presented a sensitivity of 100% and a specificity of 99.4%. CONCLUSION: The determination of drain amylase levels after RYGB was a significant indicator of leaks, hospital stay, and 30-day reoperations. This finding reinforces the importance of abdominal drainage in the RYGB within this context.
Authors: Maria Paula Carlin Cambi; Giorgio Alfredo Pedroso Baretta; Daniéla De Oliveira Magro; Cesar Luiz Boguszewski; Igor Braga Ribeiro; Pichamol Jirapinyo; Diogo Turiani Hourneaux de Moura Journal: Obes Surg Date: 2021-01-03 Impact factor: 4.129
Authors: Lucia Romano; Antonio Giuliani; Marino Di Furia; Danilo Meloni; Giovanni Cianca; Antonella Mattei; Fabiana Fiasca; Emilio Tonelli; Francesco Carlei; Mario Schietroma Journal: Med Princ Pract Date: 2021-06-22 Impact factor: 1.927
Authors: Sérgio Alexandre Barrichello Junior; Igor Braga Ribeiro; Ricardo José Fittipaldi-Fernandez; Ana Carolina Hoff; Diogo Turiani Hourneaux de Moura; Mauricio Kazuyoshi Minata; Thiago Ferreira de Souza; Manoel Dos Passos Galvão Neto; Eduardo Guimarães Hourneaux de Moura Journal: Endosc Int Open Date: 2018-11-07
Authors: Igor Braga Ribeiro; Wanderley Marques Bernardo; Bruno da Costa Martins; Diogo Touriani Hourneau de Moura; Elisa Ryoka Baba; Iatagan Rocha Josino; Nelson Tomio Miyahima; Martin Andrés Coronel Cordero; Thiago Arantes de Carvalho Visconti; Edson Ide; Paulo Sakai; Eduardo Guimarães Hourneau de Moura Journal: Endosc Int Open Date: 2018-05-08