Drain selection reduces pancreatic fistulae risk: a propensity-score matched study.
Hepatogastroenterology
; 62(138): 485-92, 2015.
Article
en En
| MEDLINE
| ID: mdl-25916087
ABSTRACT
BACKGROUND/AIMS:
Appropriate drainage management after pancreaticoduodenectomy (PD) is important to prevent and manage serious complications. This prospective study evaluated postoperative complications with either closed or open drainage placement after PD.METHODOLOGY:
The incidence of postoperative complications in patients of PD, assigned to 2 groups of closed- and open-drain systems based on assessment periods, were investigated using propensity scores matching (PSM) after accounting for potential covariates.RESULTS:
Baseline characteristics were comparable in both groups of patients [n = 100; open, 36; closed, 64). Pancreatic fistulae requiring clinical treatment, and wound infection, were found in 33.3% and 15.6%, and 22.2% and 0%, of patients in open- and closed-drainage groups, respectively. Drainage fluid culture showed exogenous infection (63.6% of bacteria) in the open-drain group which was absent in the closed-drainage group. PSM cohorts had 26 patients in either group. Following PSM, pancreatic fistulae requiring treatment were found in 12/26 (46.2%) and 3/26 (11.5%) of patients in the open- and closed-drain groups (RR, 0.25, 95% CI, 0.08-0.81), respectively. Intra-abdominal abscess (5/26 [19.2%]) and wound infection (7/26 [26.9%]) were found in the open-drain group only.CONCLUSION:
These results indicate postoperative retrograde infections may be prevented, and the incidence of pancreatic fistula reduced, with a closed drainage system.
Buscar en Google
Banco de datos:
MEDLINE
Asunto principal:
Drenaje
/
Fístula Pancreática
/
Pancreaticoduodenectomía
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Año:
2015
Tipo del documento:
Article