Skip to main content

Operative drainage following pancreatic resection: analysis of 1122 patients resected over 5 years at a single institution.

Publication ,  Journal Article
Correa-Gallego, C; Brennan, MF; Dʼangelica, M; Fong, Y; Dematteo, RP; Kingham, TP; Jarnagin, WR; Allen, PJ
Published in: Ann Surg
December 2013

BACKGROUND: The only prospective randomized trial evaluating the use of intraperitoneal drainage following pancreatic resection was published from our institution approximately 10 years ago. The current study sought to evaluate the evolution of practice over the last 5 years. PATIENTS AND METHODS: Between June 2006 and June 2011, there were 1122 resections performed. Six surgeons were evenly grouped and compared by practice pattern: routine drainers (drains placed > 95%), selective drainers, and routine nondrainers (drains placed ∼15%). Prospectively recorded preoperative, operative, and morbidity data were assessed in uni- and multivariate models. RESULTS: Our operative drainage rate was 49% and decreased over time (62% 2006-2008 vs 37% 2009-2011, P < 0.001). Patients without operative drains had significantly lower grade ≥3 overall morbidity (26% vs 33%; P = 0.01), shorter hospital stays (7 vs 8 days; P < 0.01), fewer readmissions (20% vs 27%; P = 0.01), and lower rates of grade ≥3 pancreatic fistula (16% vs 20%; P = 0.05). Similar reoperation (both <1%), interventional radiology procedures (15% vs 19%; P = 0.1), and mortality rates (2% vs 1%; P = 0.3) were seen in both groups. There were no differences between the routine drainers group (n = 248) and the nondrainers group (n = 478) in grade ≥3 fistula or need for interventional radiology-guided procedures. CONCLUSIONS: In this study, operative drains were used nearly half of the time and were associated with longer hospital stay, and higher grade ≥3 morbidity, fistula, and readmission rates. They did not decrease the need for reintervention or alter mortality rates. Routine prophylactic drainage after pancreatic resection could be safely abandoned.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

December 2013

Volume

258

Issue

6

Start / End Page

1051 / 1058

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Surgery
  • Prospective Studies
  • Postoperative Complications
  • Postoperative Care
  • Pancreatectomy
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Correa-Gallego, C., Brennan, M. F., Dʼangelica, M., Fong, Y., Dematteo, R. P., Kingham, T. P., … Allen, P. J. (2013). Operative drainage following pancreatic resection: analysis of 1122 patients resected over 5 years at a single institution. Ann Surg, 258(6), 1051–1058. https://doi.org/10.1097/SLA.0b013e3182813806
Correa-Gallego, Camilo, Murray F. Brennan, Michael Dʼangelica, Yuman Fong, Ronald P. Dematteo, T Peter Kingham, William R. Jarnagin, and Peter J. Allen. “Operative drainage following pancreatic resection: analysis of 1122 patients resected over 5 years at a single institution.Ann Surg 258, no. 6 (December 2013): 1051–58. https://doi.org/10.1097/SLA.0b013e3182813806.
Correa-Gallego C, Brennan MF, Dʼangelica M, Fong Y, Dematteo RP, Kingham TP, et al. Operative drainage following pancreatic resection: analysis of 1122 patients resected over 5 years at a single institution. Ann Surg. 2013 Dec;258(6):1051–8.
Correa-Gallego, Camilo, et al. “Operative drainage following pancreatic resection: analysis of 1122 patients resected over 5 years at a single institution.Ann Surg, vol. 258, no. 6, Dec. 2013, pp. 1051–58. Pubmed, doi:10.1097/SLA.0b013e3182813806.
Correa-Gallego C, Brennan MF, Dʼangelica M, Fong Y, Dematteo RP, Kingham TP, Jarnagin WR, Allen PJ. Operative drainage following pancreatic resection: analysis of 1122 patients resected over 5 years at a single institution. Ann Surg. 2013 Dec;258(6):1051–1058.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

December 2013

Volume

258

Issue

6

Start / End Page

1051 / 1058

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Surgery
  • Prospective Studies
  • Postoperative Complications
  • Postoperative Care
  • Pancreatectomy
  • Male
  • Humans
  • Female