Keywords
Pancreatic fistula
Pancreaticoduodenectomy
How to Cite
Abstract
Background: Pancreaticoduodenectomy is technically challenging surgery with high complications rate, often requiring surgical drains for potential complication management. However, the necessity and effectiveness of routine drainage remain debated.
Objectives: To evaluate the utility of the fistula risk score in guiding abdominal cavity drain placement decisions for pancreaticoduodenectomy patients.
Methods: A single-centered, descriptive study was conducted during 1st February 2022 to 31st January 2023 among 33 patients undergoing pancreaticoduodenectomy. Intraoperative decision-making regarding drain placement was guided by fistula risk scores. We closely monitored clinical outcomes, duration of hospital and intensive care unit stays, and other postoperative complications including clinically relevant post operative pancreatic fistula.
Results: Drain placement was avoided in seven (21.2%) patients with negligible or low fistula risk score, and only one (3.0%) patient required subsequent intervention. Biochemical leaks and clinically relevant postoperative pancreatic fistulas occurred in five (15.1%) and three (9.1%) respectively. No significant difference was observed in hospital and intensive care unit stay between drain and no drain group.
Conclusion: Abdominal drainage after pancreaticoduodenectomy should be tailored to individual risk profiles. Routine drainage may not be necessary for low-risk patients but effectively manages complications when required.
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