Early vs late drain removal after pancreatic resection—a systematic review and meta-analysis

Wu, Andrew Guan Ru; Mohan, Ramkumar; Fong, Khi Yung; Chen, Zhaojin; Bonney, Glenn Kunnath; Kow, Alfred Wei Chieh; Ganpathi, Iyer Shridhar; Pang, Ning Qi

doi:10.1007/s00423-023-03053-6

Cited by 4 publications

(1 citation statement)

References 45 publications

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“…Second, this study employed a delayed timing for CT scans performed on POD 6 or 7. Considering the current trend of earlier drain removal in the field of pancreatic surgery, 26 the evaluation of PFC status during an earlier postoperative period would be more clinically reasonable. In this regard, an earlier assessment of fluid accumulation, such as through a less complex echographic examination, may be necessary before drain removal in selected cases.…”

Section: Discussionmentioning

confidence: 99%

Assessing Intra‐abdominal status for clinically relevant postoperative pancreatic fistula based on postoperative fluid collection and drain amylase levels after distal pancreatectomy

Mukai,

Asukai,

Akita

et al. 2023

Annals of Gastroent Surgery

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AimThe aim of this study was to evaluate the intra‐abdominal status related to postoperative pancreatic fistula by combining postoperative fluid collection and drain amylase levels.MethodsWe retrospectively reviewed the data of 203 patients who underwent distal pancreatectomy and classified their postoperative abdominal status into four groups based on postoperative fluid collection size and drain amylase levels. We also evaluated the incidence of clinically relevant postoperative pancreatic fistula in each group according to C‐reactive protein values.ResultsThe incidence of clinically relevant postoperative pancreatic fistula in the entire cohort (n = 203) was 28.1%. Multivariate analysis revealed that postoperative fluid collection, drain amylase levels, and C‐reactive protein levels are considerable risk factors for clinically relevant postoperative pancreatic fistula. In the subgroup with large postoperative fluid collection and high drain amylase levels, 65.9% of patients developed clinically relevant postoperative pancreatic fistula. However, no significant difference was observed in C‐reactive protein levels between patients with clinically relevant postoperative pancreatic fistula and those without it. In contrast, in the subgroup with a large postoperative fluid collection size or a high amylase level alone, a significant difference was observed in C‐reactive protein values between the patients with clinically relevant postoperative pancreatic fistula and those without it.ConclusionPostoperative fluid collection status and the C‐reactive protein value provide a more precise assessment of intra=abdominal status related to postoperative pancreatic fistula after distal pancreatectomy. This detailed analysis may be a clinically reasonable approach to individual drain management.

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Section: Discussionmentioning

confidence: 99%