Prophylactic intra-peritoneal drain placement following pancreaticoduodenectomy: a systematic review and meta-analysis

World Journal of Gastroenterology : WJG
Yi-Chao WangXu-Bao Liu

Abstract

To conduct a meta-analysis comparing outcomes after pancreaticoduodenectomy (PD) with or without prophylactic drainage. Relevant comparative randomized and non-randomized studies were systemically searched based on specific inclusion and exclusion criteria. Postoperative outcomes were compared between patients with and those without routine drainage. Pooled odds ratios (OR) with 95%CI were calculated using either fixed effects or random effects models. One randomized controlled trial and four non-randomized comparative studies recruiting 1728 patients were analyzed. Patients without prophylactic drainage after PD had significantly higher mortality (OR=2.32, 95%CI: 1.11-4.85; P=0.02), despite the fact that they were associated with fewer overall complications (OR=0.62, 95%CI: 0.48-0.82; P=0.00), major complications (OR=0.75, 95%CI: 0.60-0.93; P=0.01) and readmissions (OR=0.77, 95%CI: 0.60-0.98; P=0.04). There were no significant differences in the rates of pancreatic fistula, intra-abdominal abscesses, postpancreatectomy hemorrhage, biliary fistula, delayed gastric emptying, reoperation or radiologic-guided drains between the two groups. Indiscriminate abandonment of intra-abdominal drainage following PD is associated with great...Continue Reading

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Citations

Jun 29, 2015·International Journal of Surgery·Roberto CirocchiNicola Avenia
May 25, 2016·Scandinavian Journal of Gastroenterology·Kjetil Søreide, Knut Jørgen Labori
Mar 21, 2017·The British Journal of Surgery·F J HüttnerM K Diener
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Oct 30, 2016·Journal of Visceral Surgery·P Mariani, K Slim
Jun 25, 2021·World Journal of Gastroenterology : WJG·Nikhil Gupta, Raghav Yelamanchi

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