P-P54 Interpreting trends in post-operative drain fluid amylase according to type of anastomosis used to form a pancreaticojejunostomy

Abstract Background The formation of the pancreaticojejunostomy during pancreaticoduodenectomy is most technically challenging aspect procedure, with its failure increasing rates both morbidity and mortality significantly. Early identification management a clinically relevant post-operative pancreatic fistula (CR-POPF) can be critical in reducing threat potentially avoidable harm to patient. used indicator for CR-POPF level drain fluid amylase. There are many different techniques forming anastomosis, considerable analysis but no consensus on superiority. We aimed look at our centres experience using trends we observed amylases clinical outcomes. Methods A prospective database all patients single UK centre undergoing or duodenal resection has been maintained. This includes patient demographics, diagnosis pre post operatively, operative details duration, complications, All between 1st January 2020 31st July 2021 were identified their data retrospectively analysed. Results Thirty-three underwent study period. pancreatojejunostomy was formed duct-to-mucosa anastomosis twenty-eight dunking technique five patients. mean highest amylase day one 14804.8 (range 3643-43686), three 2376.12 167-8008.6) whose drains situ 5 it 522.2 31 983. An 83.9% reduction Day One Three, followed by further 78% 3 day. (20%) had grade B fistula, two others biochemical leak. 71% lower 4274.5 15.4 41755). However this increased 11.5% Three 4766.4 46300) before falling 64.7% 1681.9 13015) Five. Eight (28.6%) – C - Conclusions In centre’s experience, type perform reconstruction pancreaticoduodenostomy significantly impacts trend important clinicians appreciate order avoid premature suspicion prevent unnecessary intervention.