Highlights
- •POPF related outcomes do not vary with drainage method following pancreatic resection.
- •Gland texture, PDAC/chronic pancreatitis histology, and EBL are risk factors for POPF in all types of pancreas resection.
- •Drain method should be per surgeon preference with consideration for patient and nursing specific factors.
Abstract
Background
Postoperative pancreatic fistula (POPF) is a feared complication in pancreatic resection.
Gravity drainage (GD) is hypothesized to reduce POPF versus closed-suction drainage
(CSD). We sought to evaluate this theory.
Methods
Six-hundred-twenty-nine patients undergoing pancreatic resection between 2013 and
2020 were analyzed with multivariable logistic regression for the outcomes of POPF
and clinically-relevant POPF (crPOPF).
Results
Three-hundred-ninety-seven patients (63.1%) underwent pancreaticoduodenectomy and
232 (36.9%) underwent distal pancreatectomy. Suction drains were placed in 588 patients
(93.5%) whereas 41 (6.5%) had GDs. One-hundred-twenty-five (27.6%) experienced a POPF;
49 (10%) crPOPFs. On multivariable analysis, suction drainage was not associated with
increased risk of POPF (OR 0.76, 95% CI 0.30–1.93, P = 0.57) or crPOPF (OR 0.99, 95%
CI 0.30–3.26, P = 0.98).
Conclusion
Suction drainage does not promote POPF when compared to GDs. Drain type should be
determined by surgeon preference, while taking into account nursing and patient-specific
considerations especially when patients are discharged with drains.
Keywords
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Article info
Publication history
Published online: March 01, 2022
Accepted:
February 25,
2022
Received in revised form:
January 28,
2022
Received:
November 15,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
