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The effectiveness and appropriate management of abdominal drains in patients undergoing elective liver resection: a retrospective analysis and prospective case series

Purpose Although many studies have concluded that prophylactic drain insertion during elective liver resection offers few advantages, we reassessed the clinical value and appropriate management of drain insertion. Methods We retrospectively studied the clinical value of abdominal drainage in 167 con...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2013-04, Vol.43 (4), p.372-380
Main Authors: Tanaka, Kuniya, Kumamoto, Takafumi, Nojiri, Kazunori, Takeda, Kazuhisa, Endo, Itaru
Format: Article
Language:English
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Summary:Purpose Although many studies have concluded that prophylactic drain insertion during elective liver resection offers few advantages, we reassessed the clinical value and appropriate management of drain insertion. Methods We retrospectively studied the clinical value of abdominal drainage in 167 consecutive patients who underwent hepatectomy, focusing on drainage volumes, bilirubin concentrations, drainage fluid bacterial culture results and short-term postoperative outcomes. The results were then validated prospectively in the next 50 consecutive patients to undergo hepatectomy. Results Most of the patients with morbidities such as biliary fistulas, ascites, fluid collection or duodenal perforation (20/24 or 83 %) were treated using operative drainage tubes, avoiding the use of percutaneous drainage procedures. The values obtained with the formula (drainage fluid bilirubin concentration/serum bilirubin concentration) × drainage fluid volume, were greater on both postoperative days (POD) 2 and 3 ( P  = 0.03 and P  
ISSN:0941-1291
1436-2813
DOI:10.1007/s00595-012-0254-1