Early persistent vacuum suction drainage in patients with high risk of pancreatic fistula after pancreatico-duodenectomy

Abstract

Objective To study the function of early persistent vacuum suction drainage in patients with high risk of pancreatic fistula after pancreaticoduodenectomy (PD) . Methods From Jul. 2010 to Jun. 2013, the clinical data of 286 patients undergoing PD were retrospectively evaluated. 87 patients with high risk of pancreatic fistula were screened and then divided into early persistent vacuum suction drainage group (the observation group) and conventional drainage group (the control group) according to postoperative drainage manners. We statistically analyzed the two groups in terms of general information, blood loss, operative time, medical expenses, hospital stay, mortality and morbidity of complications such as pancreatic fistula. Results There were 40 patients screened into the observation group and 47 patients into the control group. No difference was found between the observation group and the control group in basic clinical data or surgical data. There was no statistical difference between the two groups in delayed gastric emptying, bile leakage, bleeding or the incidence of pancreatic fistula and intra-abdominal infection. The incidence of pancreatic fistula with grade B and C in the observation group was statistically lower than that of the control group (12.5% vs 34.0%, P<0.05) . The incidence of intra-abdominal infection in observation group was statistically lower than those in the control group (20.0% vs 40.4%, P<0.05) . The incidence of total complications in observation group was statistically lower than that in the control group (60.0% vs 83.0%, P<0.05) , but no difference was found between the observation group and control group in morality. Early persistent vacuum suction drainage could reduce hospital stay ( (21.93±7.14) days vs (28.70±12.45) days, P<0.05) and clinical expense ( (64.8±12.0) thousands vs (75.2±14.6) thousands, P<0.05) in patients with high risk of pancreatic fistula after PD. Conclusions Early persistent vacuum suction drainage can reduce the rate of grade B and C pancreatic fistula in patients with high risk of pancreatic fistula undergoing PD. The manner can also reduce the incidence of intra-abdominal infection, total complications and cost of hospital stay. This manner can accelerate postoperative recovery of patients undergoing PD and is worth of widely used. Key words: Pancreaticoduodenectomy; Pancreatic fistula; Drainage