The latest guidelines from the Enhanced Recovery After Surgery (ERAS®) Society stated that early drain removal after pancreatoduodenectomy (PD) is beneficial in decreasing the complications including postoperative pancreatic fistulas (POPFs). This study aimed to ascertain the actual benefits of early drain removal after PD.
The data of 450 patients who underwent PD between 2018 and 2020 were retrospectively reviewed. The surgical outcomes were compared between patients whose drains were removed within postoperative 3 days (early removal group) and after 5 days (late removal group). Logistic regression analysis was performed to identify the risk factors for clinically relevant POPFs (CR-POPFs).
Among 338 patients with drain fluid amylase levels of less than 5000 IU on the first day after surgery, the early removal group (n=81) had fewer complications and shorter hospital stays than the late removal group (n=257) (30.9% vs 54.5%, p < 0.001; 9.8 days vs 12.5 days, p = 0.030, respectively). The incidence rates of specific complications including CR-POPFs were comparable between the two groups. Risk factor analysis showed that early drain removal did not increase the risk of CR-POPFs (p = 0.163).
Although early drain removal after PD has not been identified as apparently beneficial, this study showed that it may contribute to an early return to normal life without increasing complications.
No competing interests reported.
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Posted 11 Mar, 2021
On 05 Mar, 2021
On 04 Mar, 2021
On 23 Feb, 2021
Posted 11 Mar, 2021
On 05 Mar, 2021
On 04 Mar, 2021
On 23 Feb, 2021
The latest guidelines from the Enhanced Recovery After Surgery (ERAS®) Society stated that early drain removal after pancreatoduodenectomy (PD) is beneficial in decreasing the complications including postoperative pancreatic fistulas (POPFs). This study aimed to ascertain the actual benefits of early drain removal after PD.
The data of 450 patients who underwent PD between 2018 and 2020 were retrospectively reviewed. The surgical outcomes were compared between patients whose drains were removed within postoperative 3 days (early removal group) and after 5 days (late removal group). Logistic regression analysis was performed to identify the risk factors for clinically relevant POPFs (CR-POPFs).
Among 338 patients with drain fluid amylase levels of less than 5000 IU on the first day after surgery, the early removal group (n=81) had fewer complications and shorter hospital stays than the late removal group (n=257) (30.9% vs 54.5%, p < 0.001; 9.8 days vs 12.5 days, p = 0.030, respectively). The incidence rates of specific complications including CR-POPFs were comparable between the two groups. Risk factor analysis showed that early drain removal did not increase the risk of CR-POPFs (p = 0.163).
Although early drain removal after PD has not been identified as apparently beneficial, this study showed that it may contribute to an early return to normal life without increasing complications.
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