Isil Riza Gurhan, Egin Seracettin, Ilhan Mehmet, Bademler Suleyman, Gokcek Berk, Yesiltas Metin, Hot Semih, Dikker Okan, Guloglu Recep
Ann Ital Chir. 2018;89:562-568.
Sleeve gastrectomy(SG) is a popular bariatric surgery procedure with rare but dreaded complications. Although drain amylase levels are a reliable early predictor of anastomosis leakage in oesophagectomy and pancreaticoduodenectomy, for SG have not yet been studied. We aimed to monitor drain amylase levels to ascertain their applicability for early diagnosis of gastric leakage in SG.
Twenty-four rats were randomly divided into three groups: Group A: only laparotomy and abdominal drain; Group B: laparotomy, SG, and drain; Group C: laparotomy, SG with fistula,and drain. On postoperative days 0,1,2,3, and 4, drain lavage samples were collected to measure amylase.
Groups were compared in pairs. Preoperative weights were not significantly different in any comparison. On postoperative days 0,1,2,3, and 4, drain amylase levels were found to be significantly lower in Group A than in Group B as well as in Group A than in Group C but were significantly higher in Group C than in Group B. For postoperative day 1, a receiver operating characteristic curve was done. Drain amylase levels over 1514 IU were statistically significant for leakage.
Drain amylase levels were significantly high in sleeve gastrectomy with fistula. This indicates that drain amylase level monitoring might be an easy and cheap alternative for determining staple-line leakage for high risk patients with Body Mass Index(BMI)>50kg/m2 in whom we cannot use radiological imaging.
Animal Experimental Study, Bariatric Surgery, Drain amylase, Sleeve gastrectomy, Staple-line leakage.
袖状胃切除术（SG）是一种常见的减肥手术，但有罕见却可怕的并发症。虽然引流液淀粉酶水平是食管切除术和胰十二指肠切除术中吻合口漏的可靠早期预测指标，但在袖状胃切除术中尚未进行研究。我们旨在监测引流液淀粉酶水平，以确定其在袖状胃切除术胃漏早期诊断中的适用性。
将24只大鼠随机分为三组：A组：仅开腹及置腹腔引流管；B组：开腹、袖状胃切除术及置引流管；C组：开腹、袖状胃切除术并造瘘及置引流管。在术后第0、1、2、3和4天，收集引流液灌洗样本以测量淀粉酶。
对各组进行两两比较。术前体重在任何比较中均无显著差异。在术后第0、1、2、3和4天，发现A组的引流液淀粉酶水平显著低于B组，A组也显著低于C组，但C组显著高于B组。对于术后第1天，绘制了受试者工作特征曲线。引流液淀粉酶水平超过1514 IU对漏出具有统计学意义。
造瘘的袖状胃切除术中引流液淀粉酶水平显著升高。这表明，对于体重指数（BMI）>50kg/m²的高风险患者，在无法使用影像学检查时，监测引流液淀粉酶水平可能是一种简单且廉价的确定吻合口漏的方法。
动物实验研究；减肥手术；引流液淀粉酶；袖状胃切除术；吻合口漏
