Clinical surgery-InternationalSecure placement of a peripancreatic drain after a distal pancreatectomy
Section snippets
Methods
Between 1997 and 2007, 84 consecutive patients underwent distal pancreatectomy with splenectomy electively at our institution. There were 40 men and 44 women with a mean age of 59 years (range, 26–81 y). The indication for pancreatectomy included pancreatic neoplasm (n = 59), nonpancreatic neoplasm (n = 16), and chronic pancreatitis (n = 9) (Table 1). Closure of the pancreatic stump and intraperitoneal drainage were performed at the discretion of the operating surgeon. Thirteen patients had a
Results
Fixation of the drain tip near the pancreatic stump was feasible without any complications. The drain remained in place postoperatively and was removed easily when drainage became unnecessary.
The overall morbidity rate was 27% (23 of 84 patients), and was not different between the fixed drain group and the nonfixed drain group (Table 2). Pancreatic fistula (grades B and C) was the most common complication, occurring in 15 patients (18%). The incidence was not different between the fixed drain
Comments
In the present study, the fixed drain group had a significantly lower incidence of postoperative drainage of pancreatic fistula and tended to have a shorter period for cure of pancreatic fistula than the nonfixed drain group, although the incidence of pancreatic fistula was not different between these 2 groups.
In the present patients without staple closure, the pancreatic cut surface was left open after closure of the main pancreatic duct. The conventional technique, namely suture closure of
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