Francesco Giovinazzo1, Giovanni Butturini1, Roberto Salvia1, Giuseppe Mascetta1, Daniela Monsellato1, Giovanni Marchegiani1, Paolo Pederzoli1, Claudio Bassi2,3. 1. Surgical Department, Pancreas Centre, Hospital of 'G.B.Rossi', University of Verona, Piazzale 'L.A. Scuro', 37134, Verona, Italy. 2. Surgical Department, Pancreas Centre, Hospital of 'G.B.Rossi', University of Verona, Piazzale 'L.A. Scuro', 37134, Verona, Italy. claudio.bassi@univr.it. 3. Department of Surgery, General Surgery B, P.Le L.A. Scuro 10, 37134, Verona, Italy. claudio.bassi@univr.it.
Abstract
BACKGROUND: Placement of intraperitoneal drain (ID) after abdominal surgery is a common practice. Postoperative pancreatic fistula (POPF), incidence of which ranges from 2% to more than 30%, represents the most common major complication after pancreatic resection. The goal of this paper is to review the state of the art in ID management after pancreatic resection. METHODS: Data from randomized controlled trials (RCT) are reported together with data from our institution in the period before and after the start of the two reported RCTs. RESULTS: One thousand five hundred eighty patients underwent surgical resection for pancreatic lesions at our institution from 1990 to 2010. The overall rate of POPF was 23% before and 19.5% after (p = 0.24) the performance of the RCTs. Both postoperative morbidity and average in-hospital stay were higher in the period before the RCTs (13.6 ± 11.4 versus 13.4 ± 10.3 days, respectively). CONCLUSIONS: POPF is a complex and multifactorial complication after pancreatic surgery. On the basis of the present results and review of the RCTs, the value of ID and its management after pancreatic surgery remain unclear.
BACKGROUND: Placement of intraperitoneal drain (ID) after abdominal surgery is a common practice. Postoperative pancreatic fistula (POPF), incidence of which ranges from 2% to more than 30%, represents the most common major complication after pancreatic resection. The goal of this paper is to review the state of the art in ID management after pancreatic resection. METHODS: Data from randomized controlled trials (RCT) are reported together with data from our institution in the period before and after the start of the two reported RCTs. RESULTS: One thousand five hundred eighty patients underwent surgical resection for pancreatic lesions at our institution from 1990 to 2010. The overall rate of POPF was 23% before and 19.5% after (p = 0.24) the performance of the RCTs. Both postoperative morbidity and average in-hospital stay were higher in the period before the RCTs (13.6 ± 11.4 versus 13.4 ± 10.3 days, respectively). CONCLUSIONS: POPF is a complex and multifactorial complication after pancreatic surgery. On the basis of the present results and review of the RCTs, the value of ID and its management after pancreatic surgery remain unclear.
Authors: Aart A van der Wilt; Mariëlle M E Coolsen; Ignace H J T de Hingh; Gert Jan van der Wilt; Hans Groenewoud; Cornelis H C Dejong; Ronald M van Dam Journal: HPB (Oxford) Date: 2012-11-30 Impact factor: 3.647
Authors: Francesco Giovinazzo; Ralph Linneman; Giulio Valentino Dalla Riva; Daniele Greener; Christopher Morano; Gijs A Patijn; Mark G H Besselink; Vincent B Nieuwenhuijs; Mohammad Abu Hilal; I H de Hingh; G Kazemier; S Festen; K P de Jong; C H J van Eijck; J J G Scheepers; M van der Kolk; M den Dulk; K Bosscha; D Boerma; E van der Harst; T Armstrong; A Takhar; Zaed Hamady Journal: Updates Surg Date: 2021-03-26