High Values of Drain Fluid Epidermal Growth Factor and Transforming Growth Factor-Beta Are Associated with the Development of Pancreatic Fistula after Pancreatoduodenectomy

Abstract

<b><i>Introduction:</i></b> Postoperative inflammatory response may act as a major determinant of anastomotic failure after pancreaticoduodenectomy. In this pilot study, we investigated the potential role of drain fluid cytokines in predicting postoperative pancreatic fistula (POPF). <b><i>Methods:</i></b> Drain fluid TGF-β, IGF-1, EGF, and IL-6, together with serum amylase and drain fluid amylase, were measured on POD1 and correlated with the development of POPF. <b><i>Results:</i></b> The study population consisted of 66 patients. POPF and Clavien-Dindo ≥3 morbidity rates were 12.1% and 9.1%, respectively. Patients developing POPF presented significantly higher values of POD1 serum amylase level (477 vs. 54 UI/L, <i>p</i> &#x3c; 0.001), drain fluid amylase (7,500 vs. 127 UI/L, <i>p</i> &#x3c; 0.001), TGFβ (94 vs. 40 pg/g, <i>p</i> = 0.045), and EGF (17 vs. 13, <i>p</i> = 0.015). There were no differences in terms of IGF-1 and IL-6 values. <b><i>Conclusion:</i></b> Assessing the local inflammatory response after pancreatoduodenectomy could represent a promising field of research since both TGFβ and EGF seem to be associated with the occurrence of POPF.