Is Intra-Abdominal Drainage Necessary after Pancreaticoduodenectomy?

Martin J. Heslin, Lawrence Harrison, Ari D. Brooks, Steven N. Hochwald, Daniel G. Coit, Murray F. Brennan

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Closed suction drains after pancreaticoduodenectomy are theoretically used to drain potential collections and anastomotic leaks. It is unknown whether such drains are effective, harmful, or affect the outcome after this operation. Eighty-nine consecutive patients underwent pancreaticoduodenectomy for presumed periampullary malignancy and were retrospectively reviewed. Thirty-eight had no intra-abdominal drains and 51 had drains placed at the conclusion of the operation. We analyzed patient, nutritional, laboratory, and operating room factors with end points being complications and length of hospital stay. Intra-abdominal complications were defined as intra-abdominal abscess and pancreatic or biliary fistula. Postoperative interventions were defined as CT-guided drainage and reoperation. Analysis was by Student's t test and chi-square test. Two of eight surgeons contributed 92% of the patients without drains. The groups were equivalent with respect to demographic, nutritional, and operative factors. Time under anesthesia was significantly shorter in the group without drains (P = 0.0001). There was no statistical difference in the rate of fistula, abscess, CT drainage, or length of hospital stay. Intra-abdominal drainage did not significantly alter the risk of fistula, abscess, or reoperation or the necessity for CT-guided intervention after pancreaticoduodenectomy. Routine use of drains after pancreaticoduodenectomy may not be necessary and should be subjected to a randomized trial.

Original languageEnglish (US)
Pages (from-to)373-378
Number of pages6
JournalJournal of Gastrointestinal Surgery
Volume2
Issue number4
DOIs
StatePublished - Jan 1 1998

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Pancreaticoduodenectomy
Drainage
Length of Stay
Reoperation
Abscess
Fistula
Biliary Fistula
Abdominal Abscess
Pancreatic Fistula
Anastomotic Leak
Suction
Operating Rooms
Chi-Square Distribution
Anesthesia
Demography
Students
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology

Cite this

Heslin, Martin J. ; Harrison, Lawrence ; Brooks, Ari D. ; Hochwald, Steven N. ; Coit, Daniel G. ; Brennan, Murray F. / Is Intra-Abdominal Drainage Necessary after Pancreaticoduodenectomy?. In: Journal of Gastrointestinal Surgery. 1998 ; Vol. 2, No. 4. pp. 373-378.
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Is Intra-Abdominal Drainage Necessary after Pancreaticoduodenectomy? / Heslin, Martin J.; Harrison, Lawrence; Brooks, Ari D.; Hochwald, Steven N.; Coit, Daniel G.; Brennan, Murray F.

In: Journal of Gastrointestinal Surgery, Vol. 2, No. 4, 01.01.1998, p. 373-378.

Research output: Contribution to journalArticle

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