Efficacy of a Blake drainR on pancreatic fistula after pancreaticoduodenectomy.
OBJECTIVE
The aim of this study was to evaluate the efficacy of the Blake drain for the management of pancreatic fistula (PF) in comparison with the Duple drain.


METHODS
Our study consisted of two parts: a retrospective review of 33 patients with PF after pancreaticoduodenectomy, and a basic experiment to investigate the effects of the Blake drain on the management of PF in an animal model.


RESULTS
In the clinical study, 19 patients received Blake drains (B-group) and 14 received Duple drains (D-group). Grade C fistulas with abdominal bleeding developed in only 2 patients in the B-group. All the patients in the B-group healed with conservative treatment (P<0.01). and none of them required percutaneous drainage or reoperation (P<0.05). In the basic experiment, no collections of fluid were detected around the Blake drains. When leakage occurred, it did not lead to abdominal abscess, and a "drain canal" formation linking the anastomosis with the extracorporeal orifice was demonstrated all along the drainage route.


CONCLUSIONS
Blake drains may be efficient therapeutic tools in patients with grade B fistulas. The basic experiment affirms that Blake drains provide excellent drainage and contribute to the formation of "drain canals" effective in localizing and controlling PF.
Aimoto
Takayuki
T
Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. aimoto@nms.ac.jp
Uchida
Eiji
E
Nakamura
Yoshiharu
Y
Matsushita
Akira
A
Katsuno
Akira
A
Chou
Kazumitsu
K
Kawamoto
Masao
M
Taniai
Nobuhiko
N
Yoshida
Hiroshi
H
Tajiri
Takashi
T
D000368:Aged; D000818:Animals; D004285:Dogs; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000628:therapy*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*