title: Efficacy of a Blake drainR on pancreatic fistula after pancreaticoduodenectomy.
abstract: 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.
authors.affiliation: Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. aimoto@nms.ac.jp
authors.forename: Takayuki
authors.initials: T
authors.lastname: Aimoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Akira
authors.initials: A
authors.lastname: Matsushita
authors.forename: Akira
authors.initials: A
authors.lastname: Katsuno
authors.forename: Kazumitsu
authors.initials: K
authors.lastname: Chou
authors.forename: Masao
authors.initials: M
authors.lastname: Kawamoto
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
mesh_terms: 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*