@article{oai:nagasaki-u.repo.nii.ac.jp:00001416,
 author = {Adachi, Tomohiko and Ono, Shinichiro and Matsushima, Hajime and Soyama, Akihiko and Hidaka, Masaaki and Takatsuki, Mitsuhisa and Eguchi, Susumu},
 journal = {Journal of Surgical Research},
 month = {Feb},
 note = {Backgrounds: Prior studies have suggested that drain amylase level is a predictive marker for developing pancreatic fistulas (PFs) after pancreaticoduodenectomy (PD). However, means of preventing PF after discovering high drain amylase levels have not been previously established. The purpose of this study was to evaluate the efficacy of a combination drug therapy (using three drugs; gabexate mesilate, octreotide, and carbapenem antibiotics, named as triple-drug therapy [TDT]) regimen in preventing PF for patients with high drain amylase levels on postoperative day (POD) 1 after PD. Materials and methods: We divided the 183 patients who underwent PD into two groups in accordance with their enrollment in the study: for those enrolled early in the study (early period), TDT was not administered to 
patients with high drain amylase level; however, for those enrolled later in the study (late period), TDT was administered if drain amylase levels were over 10,000 IU/L on POD 1. We retrospectively compared the incidence of PF between the two groups. Results: Incidences of PFs were statistically, significantly prevented in the late group (early 17% versus late 6%; P = 0.01). For patients with low levels of drain amylase (<10,000 IU/L), the PF ratio 
was equivalent between two groups (early 8% versus late 5%; P = 0.56); however, PFs in 
patients with high drain amylase levels in the late period group were dramatically 
prevented by TDT administration (early 89% versus late 11%; P < 0.001). Conclusions: TDT may be a promising therapy to prevent PFs in patients with high drain amylase levels after PD., Journal of Surgical Research, 234, pp.77-83; 2019},
 pages = {77--83},
 title = {Efficacy of Triple-Drug Therapy to Prevent Pancreatic Fistulas in Patients With High Drain Amylase Levels After Pancreaticoduodenectomy},
 volume = {234},
 year = {2019}
}