The role of abdominal drainage in pancreatic resection - A multicenter validation study for early drain removal

Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
R J A LinnemannDutch Pancreatic Cancer Group

Abstract

Abdominal drainage and the timing of drain removal in patients undergoing pancreatic resection are under debate. Early drain removal after pancreatic resection has been reported to be safe with a low risk for clinical relevant postoperative pancreatic fistula (CR-POPF) when drain amylase on POD1 is < 5000U/L. The aim of this study was to validate this algorithm in a large national cohort. Patients registered in the Dutch Pancreatic Cancer Audit (2014-2016) who underwent pancreatoduodenectomy, distal pancreatectomy or enucleation were analysed. Data on post-operative drain amylase levels, drain removal, postoperative pancreatic fistulae were collected. Univariate and multivariate analysis using a logistic regression model were performed. The primary outcome measure was grade B/C pancreatic fistula (CR-POPF). Among 1402 included patients, 433 patients with a drain fluid amylase level of <5000U/L on POD1, 7% developed a CR-POPF. For patients with an amylase level >5000U/L the CR-POPF rate was 28%. When using a cut-off point of 2000U/L or 1000U/L during POD1-3, the CR-POPF rates were 6% and 5% respectively. For patients with an amylase level of >2000U/L and >1000UL during POD 1-3 the CR-POPF rates were 26% and 22% respectively (n =...Continue Reading

Citations

Mar 30, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Toshimitsu IwasakiKazuaki Shimada
Dec 29, 2020·Journal of Visceral Surgery·J VeziantK Slim
May 1, 2021·Journal of Clinical Medicine·Madhivanan Elango, Vassilios Papalois
Aug 19, 2021·Revista da Associação Médica Brasileira·Pablo Henrique Brito da RosaFranz Robert Apodaca Torrez

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