Early versus late drain removal after standard pancreatic resections: results of a prospective randomized trial

Annals of Surgery
Claudio BassiPaolo Pederzoli

Abstract

The role of surgically placed intra-abdominal drainages after pancreatic resections has not been clearly established. In particular, their effect on morbidity rates and the optimal timing for their removal remains controversial. A total of 114 eligible patients who underwent standard pancreatic resections and at low risk of postoperative pancreatic fistula according to our institutional protocol (amylase value in drains < or =5000 U/L on postoperative day [POD] 1) were randomized on POD 3 to receive either early (POD 3) or standard drain removal (POD 5 or beyond). The primary end point of the study was the incidence of pancreatic fistula. Secondary endpoints included abdominal complications, pulmonary complications, in-hospital stay, and perioperative mortality. Cost-analysis between the 2 groups was also made. Early drain removal was associated with a decreased rate of pancreatic fistula (P = 0.0001), abdominal complications (P = 0.002), and pulmonary complications (P = 0.007). Median in-hospital stay was shorter (P = 0.018), and hospital costs decreased (P = 0.02). Mortality was nil. A significant association with pancreatic fistula was found for timing of drain removal (P < 0.001), unintentional weight decrease before surger...Continue Reading

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Citations

Mar 16, 2011·Langenbeck's Archives of Surgery·Karolin GrafIris Freya Chaberny
Oct 22, 2013·Langenbeck's Archives of Surgery·Christina HaaneSoeren Torge Mees
Mar 25, 2011·Surgery Today·Giuseppe MalleoClaudio Bassi
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