Recalibrating Drain Fluid Amylase Cutoffs for Safer Early Removal and Fewer Complications after Pancreatoduodenectomy

Researchers recalibrated drain fluid amylase (DFA) cutoffs for early removal post-pancreatoduodenectomy (PD) in a study of 267 patients. For low-risk patients, maintaining 100% sensitivity, DFA1 < 286 and DFA3 < 97 ensured no clinically relevant postoperative pancreatic fistulas (CR-POPF). In high-risk patients, DFA1 < 137 and DFA3 < 56 achieved 100% sensitivity. The recalibrated thresholds, implemented in a learning health system, provide institution-specific criteria for optimizing safe early drain removal after PD, potentially applicable to other centers.