The role of abdominal drainage in pancreatic resection – A multicenter validation for early drain removal

Abstract

pancreaticoduodenectomy (PD). Nowadays there exist modern intraabdominal vacuum techniques as an option of therapy besides the pancreatectomy of the rest. Methods: In our hospital we have treated two patients with type C POPF with intraabdominal vacuum bandages. For this we intraabdominally placed a silicone-coated (Mepi-thel®) polyurethane sponge (V.A.C.® GranuFoam™) under a continuous suction of between 75 and 125 mmHg at the target place. One of the applications was carried out via open surgery while the other one was done laparoscopically. In both cases the vacuum bandages have been repeatedly changed and finally an open wound management via wound tamponade was applied until the wounds healed definitely. Results: From January 2013 to December 2016 161 pancreatic surgeries have been carried out in our hospital. 100 cases thereof were PD with a total fistula rate of 16% (16/100). Among these there have been two cases of type A POPF (2%), 11 cases of type B POPF (11%) and three cases of type C POPF (3%). Two cases of type C POPF could be treated successfully by the use of intraabdominal vacuum bandages. No rest pancreatectomies have been necessary. Conclusion: The experiences in our hospital have shown that the above intraabdominal vacuum technique represents a sensible therapy option in the treatment of type C POPF and that by the use of a rest pancreatectomy can be avoided.

Drain fluid biomarkers for the diagnosis of clinically relevant postoperative pancreatic fistula: a diagnostic accuracy systematic review and meta-analysis

“…Selection bias was a risk for several QUADAS-2 questions in the ‘flow and timing’ domain. Fourteen studies did not include all patients in their analysis 21 , 30 – 42 . Most of the included studies reported test accuracy through sensitivity and specificity rather than 2×2 tables.…”