Yunxiao Lyu1, Yunxiao Cheng2, Bin Wang2, Sicong Zhao2, Liang Chen2. 1. Department of Hepatobiliary Surgery, Dongyang People's Hospital, 60 West Wuning Road, Dongyang, Zhejiang Province, 322100, China. lvyunxiao1986@gmail.com. 2. Department of Hepatobiliary Surgery, Dongyang People's Hospital, 60 West Wuning Road, Dongyang, Zhejiang Province, 322100, China.
Abstract
BACKGROUND: Peritoneal drainage has been used routinely after pancreaticoduodenectomy (PD) or distal pancreatectomy (DP). Our objective was to compare patients' outcomes after PD or DP with or without peritoneal drainage. METHODS: We performed a systematic search using the following databases: PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov until 1 June 2019. We included trials comparing no peritoneal drainage versus drainage after PD and/or DP. RESULTS: Ten trials involving 2419 patients were eligible for inclusion. The meta-analysis showed a significantly lower rate of postoperative pancreatic fistula in the no-drain group (odds ratio [OR] 0.39; 95% confidence interval [CI] 0.29-0.51; p < 0.00001). However, there was no significant difference in the analysis of the subgroups, DP and DP + PD peritoneal drainage (p = 0.10, p = 0.19; respectively). The analysis of all studies showed no significant difference between groups regarding clinically related postoperative pancreatic fistula (OR 0.71; 95% CI 0.41-1.24; p = 0.23). Mortality was higher in the drain group in the PD + DP subgroup (OR 0.41; 95% CI 0.27-0.62; p < 0.0001). No significant differences were found regarding intra-abdominal abscess, delayed gastric emptying, biliary fistula, postoperative hemorrhage, or morbidity. CONCLUSION: Our results showed comparable outcomes for PD and DP with or without drainage. However, we can draw no clear conclusions because of the study limitations. Further studies on this topic are recommended.
BACKGROUND: Peritoneal drainage has been used routinely after pancreaticoduodenectomy (PD) or distal pancreatectomy (DP). Our objective was to compare patients' outcomes after PD or DP with or without peritoneal drainage. METHODS: We performed a systematic search using the following databases: PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov until 1 June 2019. We included trials comparing no peritoneal drainage versus drainage after PD and/or DP. RESULTS: Ten trials involving 2419 patients were eligible for inclusion. The meta-analysis showed a significantly lower rate of postoperative pancreatic fistula in the no-drain group (odds ratio [OR] 0.39; 95% confidence interval [CI] 0.29-0.51; p < 0.00001). However, there was no significant difference in the analysis of the subgroups, DP and DP + PD peritoneal drainage (p = 0.10, p = 0.19; respectively). The analysis of all studies showed no significant difference between groups regarding clinically related postoperative pancreatic fistula (OR 0.71; 95% CI 0.41-1.24; p = 0.23). Mortality was higher in the drain group in the PD + DP subgroup (OR 0.41; 95% CI 0.27-0.62; p < 0.0001). No significant differences were found regarding intra-abdominal abscess, delayed gastric emptying, biliary fistula, postoperative hemorrhage, or morbidity. CONCLUSION: Our results showed comparable outcomes for PD and DP with or without drainage. However, we can draw no clear conclusions because of the study limitations. Further studies on this topic are recommended.
Authors: Seung Jae Lee; In Seok Choi; Ju Ik Moon; Dae Sung Yoon; Won Jun Choi; Sang Eok Lee; Nak Song Sung; Seong Uk Kwon; In Eui Bae; Seung Jae Roh; Sung Gon Kim Journal: J Minim Invasive Surg Date: 2022-06-15