Secure placement of a peripancreatic drain after a distal pancreatectomy

Abstract 

Background

A peripancreatic drain that is placed after a distal pancreatectomy sometimes migrates and becomes ineffective postoperatively. We devised a new drainage method with fixation of the tip of a peripancreatic drain using a loose loop of an absorbable suture.

Methods

This retrospective study was performed on 84 consecutive patients who underwent a distal pancreatectomy followed by peripancreatic drainage with (n = 31) or without (n = 53) fixation.

Results

The fixed drain remained in place postoperatively and was removed easily when the drainage became unnecessary. Pancreatic fistula developed in 4 patients with and 11 patients without drain fixation, the incidence between the patients. None with and 7 patients without fixation required additional drainage (interventional or surgical) for pancreatic fistula, the difference being significant. Time to resolution of pancreatic fistula tended to be shorter after drain fixation than after nonfixation.

Conclusions

Fixation of the tip of a peripancreatic drain is a simple but useful technique for effective drainage after distal pancreatectomy.

Keywords: Distal pancreatectomy, Pancreatic fistula, Peripancreatic drainage, Drain fixation