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Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database

BACKGROUND: The optimal type of operative drainage following pancreaticoduodenectomy (PD) remains unclear. Our objective is to investigate risk associated with closed drainage techniques (passive [gravity] vs. suction) after PD. METHODS: We assessed operative drainage techniques utilized in patients...

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Autores principales: Hall, Bradley R., Egr, Zachary H., Krell, Robert W., Padussis, James C., Shostrom, Valerie K., Are, Chandrakanth, Reames, Bradley N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048035/
https://www.ncbi.nlm.nih.gov/pubmed/33853623
http://dx.doi.org/10.1186/s12957-021-02227-0
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author Hall, Bradley R.
Egr, Zachary H.
Krell, Robert W.
Padussis, James C.
Shostrom, Valerie K.
Are, Chandrakanth
Reames, Bradley N.
author_facet Hall, Bradley R.
Egr, Zachary H.
Krell, Robert W.
Padussis, James C.
Shostrom, Valerie K.
Are, Chandrakanth
Reames, Bradley N.
author_sort Hall, Bradley R.
collection PubMed
description BACKGROUND: The optimal type of operative drainage following pancreaticoduodenectomy (PD) remains unclear. Our objective is to investigate risk associated with closed drainage techniques (passive [gravity] vs. suction) after PD. METHODS: We assessed operative drainage techniques utilized in patients undergoing PD in the ACS-NSQIP pancreas-targeted database from 2016 to 2018. Using multivariable logistic regression to adjust for characteristics of the patient, procedure, and pancreas, we examined the association between use of gravity drainage and postoperative outcomes. RESULTS: We identified 9665 patients with drains following PD from 2016 to 2018, of which 12.7% received gravity drainage. 61.0% had a diagnosis of adenocarcinoma or pancreatitis, 26.5% had a duct <3 mm, and 43.5% had a soft or intermediate gland. After multivariable adjustment, gravity drainage was associated with decreased rates of postoperative pancreatic fistula (odds ratio [OR] 0.779, 95% confidence interval [CI] 0.653–0.930, p=0.006), delayed gastric emptying (OR 0.830, 95% CI 0.693–0.988, p=0.036), superficial SSI (OR 0.741, 95% CI 0.572–0.959, p=0.023), organ space SSI (OR 0.791, 95% CI 0.658–0.951, p=0.012), and readmission (OR 0.807, 95% CI 0.679–0.958, p=0.014) following PD. CONCLUSIONS: Gravity drainage is independently associated with decreased rates of CR-POPF, DGE, SSI, and readmission following PD. Additional prospective research is necessary to better understand the preferred drainage technique following PD.
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spelling pubmed-80480352021-04-15 Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database Hall, Bradley R. Egr, Zachary H. Krell, Robert W. Padussis, James C. Shostrom, Valerie K. Are, Chandrakanth Reames, Bradley N. World J Surg Oncol Research BACKGROUND: The optimal type of operative drainage following pancreaticoduodenectomy (PD) remains unclear. Our objective is to investigate risk associated with closed drainage techniques (passive [gravity] vs. suction) after PD. METHODS: We assessed operative drainage techniques utilized in patients undergoing PD in the ACS-NSQIP pancreas-targeted database from 2016 to 2018. Using multivariable logistic regression to adjust for characteristics of the patient, procedure, and pancreas, we examined the association between use of gravity drainage and postoperative outcomes. RESULTS: We identified 9665 patients with drains following PD from 2016 to 2018, of which 12.7% received gravity drainage. 61.0% had a diagnosis of adenocarcinoma or pancreatitis, 26.5% had a duct <3 mm, and 43.5% had a soft or intermediate gland. After multivariable adjustment, gravity drainage was associated with decreased rates of postoperative pancreatic fistula (odds ratio [OR] 0.779, 95% confidence interval [CI] 0.653–0.930, p=0.006), delayed gastric emptying (OR 0.830, 95% CI 0.693–0.988, p=0.036), superficial SSI (OR 0.741, 95% CI 0.572–0.959, p=0.023), organ space SSI (OR 0.791, 95% CI 0.658–0.951, p=0.012), and readmission (OR 0.807, 95% CI 0.679–0.958, p=0.014) following PD. CONCLUSIONS: Gravity drainage is independently associated with decreased rates of CR-POPF, DGE, SSI, and readmission following PD. Additional prospective research is necessary to better understand the preferred drainage technique following PD. BioMed Central 2021-04-14 /pmc/articles/PMC8048035/ /pubmed/33853623 http://dx.doi.org/10.1186/s12957-021-02227-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Hall, Bradley R.
Egr, Zachary H.
Krell, Robert W.
Padussis, James C.
Shostrom, Valerie K.
Are, Chandrakanth
Reames, Bradley N.
Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database
title Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database
title_full Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database
title_fullStr Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database
title_full_unstemmed Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database
title_short Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database
title_sort association of gravity drainage and complications following whipple: an analysis of the acs-nsqip targeted database
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048035/
https://www.ncbi.nlm.nih.gov/pubmed/33853623
http://dx.doi.org/10.1186/s12957-021-02227-0
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