Abdominal drainage was unnecessary after hepatectomy using the conventional clamp crushing technique.
A prophylactic abdominal drainage catheter is routinely inserted by many surgeons in patients after hepatic resection. Between January 2002 and September 2004, 462 consecutive patients who had undergone hepatic resection using a clamp crushing method by the same surgical team were retrospectively divided into the drainage group (n = 357) and the nondrainage group (n = 105). There was no difference in hospital mortality between the two groups of patients (drainage group, 0.6% vs. nondrainage group, 0%; P = 1.0). However, there was a greater incidence of surgical complications in the drainage group (31.4% vs. 8.6%, P < 0.001), and greater incidence of wound complications and subphrenic complications in the drainage group compared to the nondrainage group (24.4% vs. 4.8%, P < 0.001). In addition, the mean (+/- SEM) postoperative hospital stay of the drainage group was 13 +/- 6.5 days, which was significantly longer than that of the nondrainage group (9.7 +/- 3.3 days, P = 0.001). On multivariate analysis, abdominal drainage and intraoperative bleeding were the independent risk factors that were significantly associated with the incidence of drainage-related complications. The results suggested that routine abdominal drainage is unnecessary after hepatic resection when the conventional clamp crushing method is used during parenchyma transection.
Lu
Lu
L
Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Sun
Hui-Chuan
HC
Qin
Lun-Xiu
LX
Wang
Lu
L
Ye
Qin-Hai
QH
Ren
Ning
N
Fan
Jia
J
Tang
Zhao-You
ZY
D000005:Abdomen; D001201:Ascites / Q000209:etiology; D001646:Bile; D016063:Blood Loss, Surgical; D002423:Cause of Death; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013525:Surgical Instruments; D013530:Surgical Wound Infection / Q000209:etiology