Document Detail


Venting intraluminal drains in pancreaticoduodenectomy.
MedLine Citation:
PMID:  10457339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The utility of placing biliary, pancreatic, or enteric "venting"tubes (externally draining devices traversing the bowel or bile duct that have their distal tip located intraluminally near the biliary or pancreatic anastomosis) when performing a pancreaticoduodenectomy has received little attention to date. We hypothesize that these venting tubes do not decrease the morbidity or mortality associated with pancreaticoduodenectomy and may actually be a source of additional morbidity. To characterize our use of and the effect of these drains, we retrospectively analyzed 136 pancreaticoduodenectomies (127 partial, 9 total) performed over a 24-month period. Venting drain use, drain type and size, drain location, duration of intubation, hospital course, and postoperative complications were noted. Venting tubes were used in 80 patients (59%). The use of these drains had no significant relationship to postoperative length of stay, the development of major complications, overall morbidity, or mortality (P>0.05). Such drains also did not significantly shorten the length of hospital stay (P>0.05) or improve outcome when available to augment local control following luminal leak (n = 6) or regional abscess (n = 7). These drains were removed at a median interval of 29 days postoperatively (range 6 to 77 days). Seven patients had complications that were directly related to the venting drain; four of these patients had a documented intra-abdominal luminal leak from the site of drain removal, whereas the other three were hospitalized for presumed leakage secondary to immediate, severe abdominal pain following removal of the drain. These seven patients were elderly (mean age 70 years) and often harbored pancreatic ductal carcinoma (n = 6). Intraluminal drains afford no distinct advantage in terms of shortening the postoperative length of stay, decreasing operative morbidity and mortality, or improving local control with regional sepsis in pancreaticoduodenectomies. Furthermore, they may add an additional source of morbidity and we no longer employ them routinely.
Authors:
J S Fallick; D R Farley; M B Farnell; D M Ilstrup; C M Rowland
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  3     ISSN:  1091-255X     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:    1999 Mar-Apr
Date Detail:
Created Date:  2000-06-30     Completed Date:  2000-06-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  156-61     Citation Subset:  IM    
Affiliation:
Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota 55905, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Bile Ducts
Confidence Intervals
Drainage* / instrumentation,  methods,  mortality
Female
Humans
Length of Stay
Male
Medical Records
Middle Aged
Morbidity
Pancreatic Diseases / surgery*
Pancreaticoduodenectomy*
Postoperative Complications / epidemiology
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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