Droplet-based real-time detection of the amylase in patients undergoing pancreatic surgery

To improve postoperative monitoring of patients undergoing pancreatic surgery, we propose a bedside, droplet-based millifluidic device that facilitates near real-time accurate and rapid determination of drain amylase activity. Drain liquid is co-encapsulated with a starch substrate in multiple nanoliter-sized reactors to track the fluorescence intensity released upon reaction with amylase. Comparing the amylase levels of 32 patient samples, 31 out of 32 millifluidic system results (96.9%) matched the clinical data within the 95% confidence interval. Importantly, the new millifluidic strategy significantly reduces the amylase assay time from several hours to approximately 3-4 minutes and offers a ca. 10 times lower limit of detection of 0.007 µmol/sL compared to that of current clinical techniques. Finally, we for the first time demonstrate the possibility of dynamic monitoring of amylase levels in the patient samples. Thus, the proposed droplet-based instant assay system could augment state-of-the-art clinical methods and significantly improve diagnosis of postoperative complications in patients after pancreatic surgery via near-real-time bedside monitoring.