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. 2023 Nov 3;408(1):427.
doi: 10.1007/s00423-023-03165-z.

Postoperative computed tomography findings predict re-drainage cases after early drain removal in pancreaticoduodenectomy

Nobuhito Nitta  1 , Hiromitsu Maehira  2 , Hajime Ishikawa  1 , Hiroya Iida  1 , Haruki Mori  1 , Takeru Maekawa  1 , Katsushi Takebayashi  1 , Sachiko Kaida  1 , Toru Miyake  1 , Masaji Tani  1
Affiliations

Postoperative computed tomography findings predict re-drainage cases after early drain removal in pancreaticoduodenectomy

Nobuhito Nitta et al. Langenbecks Arch Surg. .

Abstract

Purpose: This study aimed to investigate the risk factors for re-drainage in patients with early drain removal after pancreaticoduodenectomy (PD).

Methods: This study retrospectively analyzed 114 patients who underwent PD and prophylactic drain removal on postoperative day (POD) 4 between January 2012 and March 2021. We analyzed the risk factors for re-drainage according to various factors. Peri-pancreaticojejunostomic fluid collection (PFC) index and pancreatic cross-sectional area (CSA) were evaluated using computed tomography on POD 4. The PFC index was calculated by multiplying the length, width, and height at the maximum aspect.

Results: Among the 114 patients, 15 (13%) underwent re-drainage due to postoperative pancreatic fistula. Multivariate analysis identified a PFC index ≥ 8.16 cm3 on POD 4 (odds ratio [OR], 20.40, 95%CI 2.38-174.00; p = 0.006) and pancreatic CSA on POD 4 ≥ 3.65 cm2 (OR, 16.40, 95%CI 1.57-171.00; p = 0.020) as independent risk factors for re-drainage.

Conclusion: A careful decision might be necessary for early drain removal in patients with a PFC index ≥ 8.16 cm3 and pancreatic CSA ≥ 3.65 cm2.

Keywords: Computed tomography; Early drain removal; Pancreatic fistula; Pancreaticoduodenectomy; Re-drainage.

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