Non-inferiority of open passive drains compared with closed suction drains in pancreatic surgery outcomes: A prospective observational study

Predictors of pancreatic fistula healing time after distal pancreatectomy

“…However, we recently reported a reduced incidence of positive drained fluid cultures with closed suction compared to open passive drains. 27 The difference was marked (but statistically insignificant) and probably due to the small sample size. Closed suction drains can be considered as a "cleaner" system and could potentially avoid bacterial contamination coming from skin flora, improving POPF healing time.…”

“…Unlike in PD, as the gastrointestinal tract is not opened during DP, bacteria that contaminate drained fluid enter the peritoneal cavity via surgical drains and are usually identified as skin flora. 27 Beyond a correct manipulation of surgical drains, there is not much evidence to support strategies associated with a reduced rate of bacterial infection of the drained fluid. However, we recently reported a reduced incidence of positive drained fluid cultures with closed suction compared to open passive drains.…”

Suction or Gravity: Impact of Closed-System Drain Type on the Postoperative Outcomes of Pancreatoduodenectomy

“…Previous studies on the modality of intraoperative drainage after PD have predominately examined the influence of open versus closed drainage systems and found no differences in terms of clinically relevant (CR-) POPF or other important postoperative complications. [1][2][3] As open systems are typically more cumbersome to manage, closed-system drains (CSDs) are more commonly used in clinical practice. Although surgeon preference typically dictates whether CSDs are placed to active suction (e.g., via a Jackson-Pratt bulb) or passive gravity (e.g., via a bile bag or "unclenched" Jackson-Pratt bulb), few studies have investigated the optimal method of closed-system drainage after PD.…”

“…Although surgeon preference typically dictates whether CSDs are placed to active suction (e.g., via a Jackson-Pratt bulb) or passive gravity (e.g., via a bile bag or "unclenched" Jackson-Pratt bulb), few studies have investigated the optimal method of closed-system drainage after PD. [1][2][3][4] Given the relatively high morbidity rates observed after PD, further information on the optimal method of drainage would have a significant clinical impact. Therefore, we used a nationwide cohort of patients undergoing PD to investigate the impact of CSD type (suction vs gravity) on CR-POPF and other relevant perioperative outcomes.…”

“…The optimal method of drainage after PD remains controversial as small randomized controlled trials conducted on this topic have produced conflicting results. [1][2][3][4] Jiang et al 4 randomized 160 patients to either prophylactic active or conventional passive drainage after PD. The authors found a decreased incidence of grade C POPF among patients in the active drain group.…”