Advantages and Disadvantages of Prophylactic Abdominal Drainage in Distal Pancreatectomy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-01-14

AUTHORS

Suguru Yamashita, Takeaki Ishizawa, Akihiko Ichida, Junichi Kaneko, Taku Aoki, Yoshihiro Sakamoto, Yasuhiko Sugawara, Kiyoshi Hasegawa, Norihiro Kokudo

ABSTRACT

BackgroundA 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.MethodsIn 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.ResultsPostoperative 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/m2, 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.ConclusionUse of prophylactic abdominal drains in DP seems to be effective for preventing PF from developing into fatal complications. However, definitive criteria should be established for enhancing safety and cost efficiency of DP through selective use and early removal of prophylactic drains. More... »

PAGES

1226-1235

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-015-3399-4

DOI

http://dx.doi.org/10.1007/s00268-015-3399-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1031030629

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26768889


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