Value of prophylactic abdominal drainage in 1269 consecutive cases of elective liver resection.

Abstract

BACKGROUND:

The value of prophylactic abdominal drainage in patients undergoing hepatectomy is controversial. We carried out a retrospective study to clarify the value of this procedure.

METHODS:

The study subjects were 1269 consecutive patients who underwent elective hepatectomy with drain insertion for malignant tumors without associated gastrointestinal procedures or bilio-enteric anastomosis. Symptomatic abdominal fluid collections were treated by the drain salvage method, percutaneous puncture, and/or re-operation, in that order of preference.

RESULTS:

One patient died (mortality rate, 0.07%) and 7 patients had postoperative bleeding (0.6%). Bile leakage, found in 111 (8.7%) patients, subsided with retention of the drain in 78 (70%) and use of the drain salvage technique in 8 (7.2%), whereas percutaneous puncture and re-operation were required in 11 (9.9%) and 14 (12.6%). Symptomatic fluid collection, observed in 65 (5.1%) patients, was treated by the drain salvage technique in 20 (31%) patients, while puncture and re-operation were required in 25 (38%) and 20 (31%).

CONCLUSIONS:

Placement of drains was effective in a considerable proportion of patients undergoing hepatectomy, with regard to reducing the frequency of development of subphrenic fluid collections and biliary fistula/biloma formation.

• Authors: Yusuke Kyoden, Hiroshi Imamura, Keiji Sano, Yoshifumi Beck, Yasuhiko Sugawara, Norihiro Kokudo, Masatoshi Makuuchi
• Journal: Journal of hepato-biliary-pancreatic sciences (J Hepatobiliary Pancreat Sci) Vol. 17 Issue 2 Pg. 186-92 (Mar 2010) ISSN: 1868-6982 [Electronic] Japan
• PMID: 19727544 (Publication Type: Comparative Study, Journal Article)

Topics

• Abdominal Cavity (surgery)
• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biliary Fistula (etiology, prevention & control)
• Carcinoma, Hepatocellular (surgery)
• Chylous Ascites (etiology, prevention & control)
• Drainage (methods)
• Elective Surgical Procedures (methods)
• Female
• Follow-Up Studies
• Hepatectomy (methods)
• Humans
• Intraoperative Period
• Liver Neoplasms (surgery)
• Male
• Middle Aged
• Postoperative Complications (etiology, prevention & control)
• Retrospective Studies
• Treatment Outcome
• Young Adult