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The role of abdominal drainage in pancreatic resection – A multicenter validation study for early drain removal

التفاصيل البيبلوغرافية
العنوان: The role of abdominal drainage in pancreatic resection – A multicenter validation study for early drain removal
المؤلفون: Sebastiaan Festen, Vincent B. Nieuwenhuijs, Gijs A. Patijn, Marc G. Besselink, E. van der Harst, K P de Jong, Geert Kazemier, T H Mungroop, Joris J. Scheepers, L.B. van Rijssen, M. den Dulk, I.H.J.T. de Hingh, M. van der Kolk, C.H.J. van Eijck, O.R.C. Busch, D. Boerma, R. Linnemann, Koop Bosscha
المساهمون: Groningen Institute for Organ Transplantation (GIOT), Guided Treatment in Optimal Selected Cancer Patients (GUTS), Surgery, CCA - Cancer Treatment and quality of life, AGEM - Re-generation and cancer of the digestive system, Ear, Nose and Throat, CCA - Cancer Treatment and Quality of Life, AGEM - Digestive immunity, AGEM - Endocrinology, metabolism and nutrition, Graduate School, ACS - Diabetes & metabolism, ACS - Heart failure & arrhythmias, AII - Inflammatory diseases, APH - Quality of Care, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health
المصدر: Linnemann, R J A, Patijn, G A, van Rijssen, L B, Besselink, M G, Mungroop, T H, de Hingh, I H, Kazemier, G, Festen, S, de Jong, K P, van Eijck, C H J, Scheepers, J J G, van der Kolk, M, Dulk, M D, Bosscha, K, Busch, O R, Boerma, D, van der Harst, E, Nieuwenhuijs, V B & Dutch Pancreatic Cancer Group 2019, ' The role of abdominal drainage in pancreatic resection – A multicenter validation study for early drain removal ', Pancreatology, vol. 19, no. 6, pp. 888-896 . https://doi.org/10.1016/j.pan.2019.07.041
Pancreatology, 19(6), 888-896. ELSEVIER SCIENCE BV
Pancreatology, 19(6), 888-896. S. Karger AG
Pancreatology, 19(6), 888-896. Elsevier
سنة النشر: 2019
مصطلحات موضوعية: Male, medicine.medical_specialty, Fistula, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Enucleation, PPPD, Drain, Pancreaticoduodenectomy, Pancreatectomy, Reference Values, Pancreatic cancer, Abdomen, medicine, Humans, Amylase, Pancreas, METAANALYSIS, Device Removal, Aged, Netherlands, INTRAPERITONEAL DRAINAGE, RISK, Hepatology, biology, business.industry, Gastroenterology, Middle Aged, medicine.disease, Whipple, Surgery, Pancreatic Neoplasms, medicine.anatomical_structure, Treatment Outcome, Pancreatic fistula, Amylases, biology.protein, Drainage, TRIAL, Female, Drain removal, business, Algorithms
الوصف: Background: Abdominal drainage and the timing of drain removal in patients undergoing pancreatic resection are under debate. Early drain removal after pancreatic resection has been reported to be safe with a low risk for clinical relevant postoperative pancreatic fistula (CR-POPF) when drain amylase on POD1 is Methods: Patients registered in the Dutch Pancreatic Cancer Audit (2014-2016) who underwent pancreatoduodenectomy, distal pancreatectomy or enucleation were analysed. Data on post-operative drain amylase levels, drain removal, postoperative pancreatic fistulae were collected. Univariate and multivariate analysis using a logistic regression model were performed. The primary outcome measure was grade B/C pancreatic fistula (CR-POPF).Results: Among 1402 included patients, 433 patients with a drain fluid amylase level of 5000U/L the CR-POPF rate was 28%. When using a cut-off point of 2000U/L or 1000U/L during POD1-3, the CR-POPF rates were 6% and 5% respectively. For patients with an amylase level of >2000U/L and >1000UL during POD 1-3 the CR-POPF rates were 26% and 22% respectively (n = 223). Drain removal on POD4 or thereafter was associated with more complications (p = 0.004). Drain amylase level was shown to be the most statistically significant predicting factor for CR-POPF (Wald = 49.7; p Conclusion: Our data support early drain removal after pancreatic resection. However, a cut-off of 5000U/L drain amylase on POD1 was associated with a relatively high CR-POPF rate of 7%. A cut-off point of 1000U/L during POD1-3 resulted in 5% CR-POPF and might be a safer alternative. (C) 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.
وصف الملف: application/pdf
اللغة: English
تدمد: 1424-3903
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::9b1208c5164f4d358dadb0ab05289aa2
https://doi.org/10.1016/j.pan.2019.07.041
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....9b1208c5164f4d358dadb0ab05289aa2
قاعدة البيانات: OpenAIRE
الوصف
تدمد:14243903