Routine Drainage of the Operative Bed Following Elective Distal Pancreatectomy Does Not Reduce the Occurrence of Complications

Stephen W. Behrman, Ben L. Zarzaur, Abhishek Parmar, Taylor S. Riall, Bruce L. Hall, Henry A. Pitt

    Research output: Contribution to journalArticle

    26 Citations (Scopus)

    Abstract

    Methods: : Data from the American College of Surgeons-National Surgical Quality Improvement Program Pancreatectomy Demonstration Project were utilized. The impact of drain placement on development of pancreatectomy-related and overall morbidity were analyzed. Propensity scores for drain placement were calculated, and nearest neighbor matching was used to create a matched cohort. Groups were compared using bivariate and logistic regression analyses.

    Results: : Over 14 months, 761 patients undergoing DP were accrued; 606 were drained. Propensity score matching was possible in 116 patients. Drain and no drain groups were not different with respect to multiple preoperative and operative variables. All pancreatic fistulas (p < 0.01) and overall morbidity (p < 0.05) were more common in patients who received a drain. The placement of a drain did not reduce the incidence of clinically relevant pancreatic fistula nor the need for postoperative procedures.

    Conclusions: : Placement of drains following elective distal pancreatectomy was associated with a higher overall morbidity and pancreatic fistulas. Drains did not reduce intra-abdominal septic morbidity, clinically relevant pancreatic fistulas, nor the need for postoperative therapeutic intervention.

    Background: : Routine drainage of the operative bed following elective pancreatectomy remains controversial. Data specific to distal pancreatectomy (DP) have not been examined in a multi-institutional collaborative.

    Original languageEnglish (US)
    Pages (from-to)72-79
    Number of pages8
    JournalJournal of Gastrointestinal Surgery
    Volume19
    Issue number1
    DOIs
    StatePublished - 2014

    Fingerprint

    Pancreatectomy
    Pancreatic Fistula
    Drainage
    Morbidity
    Propensity Score
    Postoperative Care
    Quality Improvement
    Logistic Models
    Regression Analysis
    Incidence

    Keywords

    • Drain
    • Fistula
    • Outcome
    • Pancreas
    • Surgery

    ASJC Scopus subject areas

    • Surgery
    • Gastroenterology

    Cite this

    Routine Drainage of the Operative Bed Following Elective Distal Pancreatectomy Does Not Reduce the Occurrence of Complications. / Behrman, Stephen W.; Zarzaur, Ben L.; Parmar, Abhishek; Riall, Taylor S.; Hall, Bruce L.; Pitt, Henry A.

    In: Journal of Gastrointestinal Surgery, Vol. 19, No. 1, 2014, p. 72-79.

    Research output: Contribution to journalArticle

    Behrman, Stephen W. ; Zarzaur, Ben L. ; Parmar, Abhishek ; Riall, Taylor S. ; Hall, Bruce L. ; Pitt, Henry A. / Routine Drainage of the Operative Bed Following Elective Distal Pancreatectomy Does Not Reduce the Occurrence of Complications. In: Journal of Gastrointestinal Surgery. 2014 ; Vol. 19, No. 1. pp. 72-79.
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    abstract = "Methods: : Data from the American College of Surgeons-National Surgical Quality Improvement Program Pancreatectomy Demonstration Project were utilized. The impact of drain placement on development of pancreatectomy-related and overall morbidity were analyzed. Propensity scores for drain placement were calculated, and nearest neighbor matching was used to create a matched cohort. Groups were compared using bivariate and logistic regression analyses.Results: : Over 14 months, 761 patients undergoing DP were accrued; 606 were drained. Propensity score matching was possible in 116 patients. Drain and no drain groups were not different with respect to multiple preoperative and operative variables. All pancreatic fistulas (p < 0.01) and overall morbidity (p < 0.05) were more common in patients who received a drain. The placement of a drain did not reduce the incidence of clinically relevant pancreatic fistula nor the need for postoperative procedures.Conclusions: : Placement of drains following elective distal pancreatectomy was associated with a higher overall morbidity and pancreatic fistulas. Drains did not reduce intra-abdominal septic morbidity, clinically relevant pancreatic fistulas, nor the need for postoperative therapeutic intervention.Background: : Routine drainage of the operative bed following elective pancreatectomy remains controversial. Data specific to distal pancreatectomy (DP) have not been examined in a multi-institutional collaborative.",
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    AU - Hall, Bruce L.

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