Results of a randomized controlled trial comparing closed-suction drains versus passive gravity drains after pancreatic resection
Abstract
Background: This dual-center, randomized controlled trial aimed to compare 2 types of intra-abdominal drains after pancreatic resection and their effect on the development of pancreatic fistulae and postoperative complications. Methods: Patients undergoing pancreatic resection were randomized to receive either a closed-suction drain or a closed, passive gravity drain.
The primary endpoint was the rate of postoperative pancreatic fistula. A secondary endpoint was postoperative morbidity during follow-up of 3 months.
The planned sample size was 223 patients. Results: A total of 294 patients were assessed for eligibility, 223 of whom were randomly allocated.
One patient was lost during follow-up, and 111 patients in each group were analyzed. The rate of postoperative pancreatic fistula (closed-suction 43.2%, passive 36.9%, P = .47) and overall morbidity (closed-suction 51.4%, passive 40.5%, P = .43) were not different between the groups.
We did not find any differences between the groups in reoperation rate (P=.45), readmission rate (P = .27), hospital stay (P = .68), or postoperative hemorrhage (P = .11). We found a significantly lesser amount of drain fluid in the passive gravity drains between the second and fifth postoperative days and also on the day of drain removal compared with closed-suction drains.
Conclusion: The type of drain (passive versus closed suction) had no influence on the rate of postoperative pancreatic fistulae. The closed-suction drains did not increase the rate of postoperative complications.
We found that the passive gravity drains are more at risk for obstruction, whereas the closed-suction drains kept their patency for greater duration. (C) 2018 Elsevier Inc. All rights reserved.