OBJECTIVE: The aim of this study was designed to determine whether the period of drain insertion influences the incidence of postoperative complications. BACKGROUND DATA: The significance of prophylactic drains after pancreatic head resection is still controversial. No report discusses the association of the period of drain insertion and postoperative complications. METHODS: A total of 104 consecutive patients who underwent pancreatic head resection were enrolled in this study. To assess the value of prophylactic drains, we prospectively assigned the patients into 2 groups: group I underwent resection from January 2000 to January 2002 (n = 52, drain to be removed on postoperative day 8); group II underwent resection from February 2002 to December 2004 (n = 52, drain to be removed on postoperative day 4). Postoperative complications in the 2 groups were compared. RESULTS: The rate of pancreatic fistula was significantly lower in group II (3.6%) than in group I (23%) (P = 0.0038). The rate of intra-abdominal infections, including intra-abdominal abscess and infected intra-abdominal collections, was significantly reduced in group II (7.7%) compared with group I (38%) (P = 0.0003). Eighteen of 52 (34.6%) patients in group I had an inserted drain beyond 8 days, whereas only 2 of 52 (3.7%) patients in group II had an inserted drain beyond 4 days (P = 0.0002). Cultures of drainage fluid were positive in 16 of 52 (30.8%) patients in group I, and in 2 of 52 (3.7%) patients in group II (P = 0.0002). Intraoperative bleeding (> 1500 mL), operative time (> 420 minutes, and the period of drain insertion were significant risk factors for intra-abdominal infections (P = 0.043, 0.025, 0.0003, respectively). The period of drain insertion was the only independent risk factor for intra-abdominal infections by multivariate analysis (odds ratio, 6.7). CONCLUSION: Drain removal on postoperative day 4 was shown to be an independent factor in reducing the incidence of complications with pancreatic head resection, including intra-abdominal infections.
RCT Entities:
OBJECTIVE: The aim of this study was designed to determine whether the period of drain insertion influences the incidence of postoperative complications. BACKGROUND DATA: The significance of prophylactic drains after pancreatic head resection is still controversial. No report discusses the association of the period of drain insertion and postoperative complications. METHODS: A total of 104 consecutive patients who underwent pancreatic head resection were enrolled in this study. To assess the value of prophylactic drains, we prospectively assigned the patients into 2 groups: group I underwent resection from January 2000 to January 2002 (n = 52, drain to be removed on postoperative day 8); group II underwent resection from February 2002 to December 2004 (n = 52, drain to be removed on postoperative day 4). Postoperative complications in the 2 groups were compared. RESULTS: The rate of pancreatic fistula was significantly lower in group II (3.6%) than in group I (23%) (P = 0.0038). The rate of intra-abdominal infections, including intra-abdominal abscess and infected intra-abdominal collections, was significantly reduced in group II (7.7%) compared with group I (38%) (P = 0.0003). Eighteen of 52 (34.6%) patients in group I had an inserted drain beyond 8 days, whereas only 2 of 52 (3.7%) patients in group II had an inserted drain beyond 4 days (P = 0.0002). Cultures of drainage fluid were positive in 16 of 52 (30.8%) patients in group I, and in 2 of 52 (3.7%) patients in group II (P = 0.0002). Intraoperative bleeding (> 1500 mL), operative time (> 420 minutes, and the period of drain insertion were significant risk factors for intra-abdominal infections (P = 0.043, 0.025, 0.0003, respectively). The period of drain insertion was the only independent risk factor for intra-abdominal infections by multivariate analysis (odds ratio, 6.7). CONCLUSION: Drain removal on postoperative day 4 was shown to be an independent factor in reducing the incidence of complications with pancreatic head resection, including intra-abdominal infections.
Authors: C J Yeo; J L Cameron; T A Sohn; K D Lillemoe; H A Pitt; M A Talamini; R H Hruban; S E Ord; P K Sauter; J Coleman; M L Zahurak; L B Grochow; R A Abrams Journal: Ann Surg Date: 1997-09 Impact factor: 12.969
Authors: Parul J Shukla; Savio G Barreto; Mms Bedi; N Bheerappa; Adarsh Chaudhary; Md Gandhi; M Jacob; S Jesvanth; Dg Kannan; Vinay K Kapoor; A Kumar; Kk Maudar; Hariharan Ramesh; Ra Sastry; Rajan Saxena; Ajit Sewkani; S Sharma; Shailesh V Shrikhande; A Singh; Rajneesh K Singh; R Surendran; Subodh Varshney; V Verma; V Vimalraj Journal: HPB (Oxford) Date: 2009-12 Impact factor: 3.647
Authors: Markus K Diener; Keyvan Tadjalli-Mehr; Keyvan-Tadjalli Mehr; Moritz N Wente; Meinhard Kieser; Markus W Büchler; Christoph M Seiler Journal: Langenbecks Arch Surg Date: 2010-10-21 Impact factor: 3.445
Authors: Matthew T McMillan; Giuseppe Malleo; Claudio Bassi; Michael H Sprys; Charles M Vollmer Journal: HPB (Oxford) Date: 2015-09-16 Impact factor: 3.647