1. Early Drain Removal Regardless of Drain Fluid Amylase Level Might Reduce Risk of Postoperative Pancreatic Fistula
- Author
-
Hidenori Akaike, Shinji Furuya, Jun Itakura, Daisuke Ichikawa, Katsutoshi Shoda, Yoshihiko Kawaguchi, Takashi Nakayama, Naohiro Hosomura, Hiromichi Kawaida, Hidetake Amemiya, Yuuki Nakata, Hiroki Shimizu, Yudai Higuchi, Isamu Tsukahara, Naoki Ashizawa, Makoto Sudo, Hideki Fujii, Hiroshi Kono, and Ryo Saito
- Subjects
Cancer Research ,medicine.medical_specialty ,Time Factors ,Abdominal cavity ,Gastroenterology ,Pancreatic Fistula ,03 medical and health sciences ,Pancreatectomy ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Humans ,Medicine ,In patient ,Amylase ,Device Removal ,Postoperative Care ,biology ,business.industry ,Incidence ,Disease Management ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Point of delivery ,ROC Curve ,Oncology ,Pancreatic fistula ,030220 oncology & carcinogenesis ,Amylases ,Pancreatic juice ,biology.protein ,Drainage ,Drain removal ,business ,Distal pancreatectomy ,Biomarkers - Abstract
BACKGROUND/AIM Drains are frequently placed at the time of distal pancreatectomy (DP) to evacuate pancreatic juice and intra-abdominal exudate and obtain information on abdominal cavity status. However, the timing of drain removal remains debatable. Meanwhile, prolonged drain placement might increase the risk of postoperative pancreatic fistula (POPF), with a prevalence of 5-40%. Therefore, we examined the effect of removing the drain within postoperative day (POD) 3 on the risk of POPF development. PATIENTS AND METHODS A total of 108 consecutive patients who underwent DP between April 2015 and March 2020 were examined and divided into two groups according to the day of drain removal; hence, for some patients, the drain was removed on POD 1 (POD 1 group) and for others on POD 3 (POD 3 group). Furthermore, risk factors, including drain fluid amylase (DFA) levels, for developing POPF were investigated. RESULTS The overall rate of clinically relevant POPF was 4.6% and did not significantly differ between the POD 1 and POD 3 groups [4.5% and 4.9%, respectively (p=0.924)]. DFA levels on POD 1 did not significantly differ between patients with and without POPF. On POD 3 and POD 5, C-reactive protein (CRP) levels were significantly higher in patients with POPF than in those without (p=0.03 and p
- Published
- 2021