Routine peritoneal drainage of the surgical bed after elective distal pancreatectomy: is it necessary?
Routine peritoneal drainage of the surgical bed after elective distal pancreatectomy: is it necessary?
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DOI：
10.1016/j.amjsurg.2012.02.005
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发表时间：
2012-10-01
影响因子：
3
通讯作者：
Behrman, Stephen W.
中科院分区：
文献类型：
--
作者：
Paulus, Elena M.;Zarzaur, Ben L.;Behrman, Stephen W.
背景：近期文献表明，择期胰腺切除术后腹膜引流（PD）并无帮助，甚至可能有害。针对远端胰腺切除术（DP）的数据此前尚未经过评估。
方法：我们对接受远端胰腺切除术的患者进行了回顾性研究。所考察的因素包括术后发病率以及是否需要治疗干预。
结果：69名患者接受了远端胰腺切除术，其中30例未进行腹膜引流。34名患者出现了45种并发症，大多数为腹腔内并发症。分别有12例、19例和3例患者需要进行放射学引流、再次手术或两者皆需。两组在腹腔内并发症或治疗干预需求方面无差异。在39例接受腹膜引流的患者中，19例出现腹部疾病。引流在3例患者中对识别和/或治疗并发症有帮助。
结论：首先，与未进行引流的患者相比，远端胰腺切除术后进行腹膜引流并不能降低发病率或减少治疗干预的需求。其次，引流对检测并发症的帮助不大。第三，建议进行一项多机构的随机研究。（C）2012爱思唯尔公司。保留所有权利。
BACKGROUND: Recent literature suggests that peritoneal drainage (PD) is not helpful after elective pancreatectomy and may be detrimental. Data specific to distal pancreatectomy (DP) have not received prior evaluation.METHODS: We performed a retrospective review of patients who underwent DP. Factors examined included postoperative morbidity and the need for therapeutic intervention.RESULTS: Sixty-nine patients had DP, 30 without PD. Thirty-four patients suffered 45 complications, most were intra-abdominal in nature. Twelve, 19, and 3 patients required radiologic drainage, reoperation, or both, respectively. There was no difference between groups relative to intra-abdominal complications or the need for therapeutic intervention. Of 39 patients undergoing PD, 19 had abdominal morbidity. The drain was useful in identifying and/or treating the complication in 3 patients.CONCLUSIONS: First, PD after DP does not confer a reduction in morbidity or the need for therapeutic intervention versus patients with no drains. Second, the presence of a drain infrequently was helpful in detecting complications. Third, a multi-institutional, randomized study is recommended. (C) 2012 Elsevier Inc. All rights reserved.