Advantages and Disadvantages of Prophylactic Abdominal Drainage in Distal Pancreatectomy

World Journal of Surgery
Suguru YamashitaNorihiro Kokudo

Abstract

A method to completely prevent postoperative pancreatic fistula (PF) in distal pancreatectomy (DP) is lacking. Hence, prophylactic abdominal drains could be used to prevent PF from developing into life-threatening complications. In 152 consecutive patients undergoing DP, three drains were placed routinely toward the pancreatic stump, supra-pancreatic space, and left subphrenic space. Abdominal drains were removed after surgery gradually based on amylase levels and positivity for bacterial infection in abdominal fluids. Postoperative symptomatic PF occurred in 57 of 152 patients (37.5 %). Prevalence of severe postoperative complications (Clavien-Dindo grade ≥ IIIa) was 16 %, with surgery-associated mortality observed in one patient (0.7 %). Prevalence of infection in drained abdominal fluids increased gradually and was >10 % on postoperative day (POD)-7. Severe postoperative complications led to longer postoperative hospital stays and higher treatment costs. Multivariate analyses revealed that a body mass index ≥ 25 kg/m(2), serum albumin level ≤ 3.8 g/dL, and white blood cell count at POD-3 ≥ 15,000/μL were independent predictors for development of severe postoperative complications. Use of prophylactic abdominal drains in DP s...Continue Reading

References

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Citations

Mar 23, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Christopher B NahmAnubhav Mittal
Mar 1, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Feng YangDeliang Fu

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