1. Routine peritoneal drainage of the surgical bed after elective distal pancreatectomy: is it necessary?
- Author
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Paulus EM, Zarzaur BL, and Behrman SW
- Subjects
- Abdominal Abscess etiology, Abdominal Abscess prevention & control, Adult, Aged, Chi-Square Distribution, Elective Surgical Procedures, Female, Humans, Male, Middle Aged, Pancreatic Fistula etiology, Pancreatic Fistula prevention & control, Pancreatic Pseudocyst etiology, Pancreatic Pseudocyst prevention & control, Postoperative Hemorrhage etiology, Postoperative Hemorrhage prevention & control, Reoperation, Retrospective Studies, Suction, Treatment Failure, Drainage adverse effects, Drainage methods, Pancreatectomy adverse effects, Peritoneal Cavity, Postoperative Complications etiology, Postoperative Complications prevention & control
- Abstract
Background: Recent literature suggests that peritoneal drainage (PD) is not helpful after elective pancreatectomy and may be detrimental. Data specific to distal pancreatectomy (DP) have not received prior evaluation., Methods: We performed a retrospective review of patients who underwent DP. Factors examined included postoperative morbidity and the need for therapeutic intervention., Results: Sixty-nine patients had DP, 30 without PD. Thirty-four patients suffered 45 complications, most were intra-abdominal in nature. Twelve, 19, and 3 patients required radiologic drainage, reoperation, or both, respectively. There was no difference between groups relative to intra-abdominal complications or the need for therapeutic intervention. Of 39 patients undergoing PD, 19 had abdominal morbidity. The drain was useful in identifying and/or treating the complication in 3 patients., Conclusions: First, PD after DP does not confer a reduction in morbidity or the need for therapeutic intervention versus patients with no drains. Second, the presence of a drain infrequently was helpful in detecting complications. Third, a multi-institutional, randomized study is recommended., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
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