Do Drains Contribute to Pancreatic Fistulae? Analysis of over 5000 Pancreatectomy Patients

Introduction Conflicting evidence exists from randomized controlled trials supporting both increased complications/fistulae and improved outcomes with drain placement after pancreatectomy. The objective was to determine drain practice patterns in the USA, and to identify if drain placement was assoc...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2018-06, Vol.22 (6), p.1007-1015
Main Authors: El Khoury, R., Kabir, C., Maker, V.K., Banulescu, M, Wasserman, M., Maker, A.V.
Format: Article
Language:English
Subjects:
Aged
Drainage - adverse effects
Drainage - statistics & numerical data
Female
Fistula
Gastroenterology
Gastrointestinal surgery
Humans
Male
Medicine
Medicine & Public Health
Middle Aged
Obesity - epidemiology
Operative Time
Organ Size
Original Article
Pancreatectomy
Pancreatectomy - adverse effects
Pancreatic Ducts - pathology
Pancreatic Fistula - epidemiology
Pancreatic Fistula - etiology
Pancreaticoduodenectomy
Pancreaticoduodenectomy - adverse effects
Patient Readmission - statistics & numerical data
Risk Factors
Surgery
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Summary:Introduction Conflicting evidence exists from randomized controlled trials supporting both increased complications/fistulae and improved outcomes with drain placement after pancreatectomy. The objective was to determine drain practice patterns in the USA, and to identify if drain placement was associated with fistula formation. Methods Demographic, perioperative, and patient outcome data were captured from the most recent annual NSQIP pancreatic demonstration project database, including components of the fistula risk score. Significant variables in univariate analysis were entered into adjusted logistic regression models. Results Of 5013 pancreatectomy patients, 4343 (87%) underwent drain placement and 18% of patients experienced a pancreatic fistula. When controlled for other factors, drain placement was associated with ducts
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-018-3702-4