Drain fluid biomarkers for prediction and diagnosis of clinically relevant postoperative pancreatic fistula: A narrative review

Table 1 Drain amylase accuracy evaluated beyond sensitivity and specificity

Ref.	Cut-off (U/L)	Predictive	Evaluated (POD)	Patients	Surgery	CR-POPF (%)	Study design	Publication
		Performance		n
Giovinazzo et al[48], 2018	350	AUC = 0.92	1	568	PD	NS	R	Abstract
Partelli et al[49], 2017	500	AUC = 0.881, OR = 21.72	1	463	PD	13.82	R	Abstract
Kerem et al[50], 2018	1363	AUC = 0.91	1	135	PD	13.33	R	Abstract
Kawai et al[51], 2009	5000	P = 0.1002 (univariate)	1	244	PD	28	R	Full paper
Teixeira et al[52], 2018	< 270	Higher median values statistically predicted CR-POPF	1	102	PD	25.5	P	Full paper
	271-5000
	> 5000
Mimura et al[53], 2012	2000	AUC = 0.81	1	240	PD	23.4	R	Abstract
Mimura et al[53], 2012	100	AUC = 0.86	5	240	PD	23.4	R	Abstract
Kawaida et al[54], 2018	860	P = 0.002 (univariate)	3	75	DP	9.3	P	Full paper
Recreo Baquedano et al[55], 2019	< 400	NPV = 0.968	3	278	PD	14	P	Abstract
Newhook et al[56], 2020	49	Sensitivity = 1	1	45	DP	24	P	Full paper
Newhook et al[56], 2020	26	Sensitivity = 1	3	45	DP	24	P	Full paper
van Dongen et al[57], 2021	100	Sensitivity = 1	2	285	PD	18.24	R	Abstract

POD: Postoperative day; AUC: Area under the receiver operating characteristic curve; OR: Odds ratio; CR-POPF: Clinically relevant postoperative pancreatic fistula; PD: Pancreatoduodenectomy; DP: Distal pancreatectomy; P: Prospective; R: Retrospective; NS: Not stated; NPV: Negative predictive value.