Publications

Authors:

van Bodegraven, Eduard A; De Pastena, Matteo; Vissers, Frederique L; Balduzzi, Alberto; Stauffer, John; Esposito, Alessandro; Malleo, Giuseppe; Marchegiani, Giovanni; Busch, Olivier R; Salvia, Roberto; van Hilst, Jony; Bassi, Claudio; Besselink, Marc G; Asbun, Horacio J

Title:

Routine prophylactic abdominal drainage versus no-drain strategy after distal pancreatectomy: A multicenter propensity score matched analysis

Year:

2022

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

Pancreatology

ISSN of journal:

1424-3903

N° Volume:

22

Number or Folder:

6

Page numbers:

797-802

Keyword:

Abdominal drainage, no-drain strategy, Distal pancreatectomy

Short description of contents:

Background: /Objectives Postoperative pancreatic fistula (POPF) remains the most common complication after distal pancreatectomy (DP). Traditionally, surgical drains are placed routinely after DP, but some question its efficacy and postulate that the use of drains may convert a self-limiting postoperative collection into a POPF. This study aimed to compare outcomes between three institutions with varying drainage strategies. Methods: The study is a retrospective propensity score-matched analysis of intraoperative prophylactic drain placement during DP (2010-2019). The primary outcome is major morbidity. Propensity score matching was used to obtain comparable groups. Results: Overall, 963 patients after DP were included. One center did not place a surgical drain routinely, but decided to place a drain when unsatisfactory pancreatic closure occurred. Prophylactic abdominal drains were placed in 805 patients (84%) of which 74 could be matched to 74 patients without a drain. The rate of major morbidity (8% vs 19%, p = 0.054) and radiological interventions (5% vs 12%, p = 0.147) were non-significantly lower in the no-drain group as compared to the prophylactic drain group, respectively. The rates of POPF (4% vs 16%, p = 0.014) were lower in the no-drain group. Conclusion: In this international retrospective multicenter study, a selective no-drain strategy after DP was not associated with higher rates major morbidity or radiological interventions as compared to routine prophylactic abdominal drainage. Although the rate of POPF was lower in the no-drain group, randomized trials should confirm the safety and outcome of a no-drain strategy after DP. (C) 2022 The Authors. Published by Elsevier B.V. on behalf of IAP and EPC.

Product ID:

131976

Handle IRIS:

11562/1086127

Last Modified:

December 29, 2023

Bibliographic citation:

van Bodegraven, Eduard A; De Pastena, Matteo; Vissers, Frederique L; Balduzzi, Alberto; Stauffer, John; Esposito, Alessandro; Malleo, Giuseppe; Marchegiani, Giovanni; Busch, Olivier R; Salvia, Roberto; van Hilst, Jony; Bassi, Claudio; Besselink, Marc G; Asbun, Horacio J, Routine prophylactic abdominal drainage versus no-drain strategy after distal pancreatectomy: A multicenter propensity score matched analysis «Pancreatology» , vol. 22 , n. 6 , 2022 , pp. 797-802

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