title: Routine peritoneal drainage of the surgical bed after elective distal pancreatectomy: is it necessary?
abstract: BACKGROUND
  Recent literature suggests that peritoneal drainage (PD) is not helpful after elective pancreatectomy and may be detrimental. Data specific to distal pancreatectomy (DP) have not received prior evaluation.
  
  
  METHODS
  We performed a retrospective review of patients who underwent DP. Factors examined included postoperative morbidity and the need for therapeutic intervention.
  
  
  RESULTS
  Sixty-nine patients had DP, 30 without PD. Thirty-four patients suffered 45 complications, most were intra-abdominal in nature. Twelve, 19, and 3 patients required radiologic drainage, reoperation, or both, respectively. There was no difference between groups relative to intra-abdominal complications or the need for therapeutic intervention. Of 39 patients undergoing PD, 19 had abdominal morbidity. The drain was useful in identifying and/or treating the complication in 3 patients.
  
  
  CONCLUSIONS
  First, PD after DP does not confer a reduction in morbidity or the need for therapeutic intervention versus patients with no drains. Second, the presence of a drain infrequently was helpful in detecting complications. Third, a multi-institutional, randomized study is recommended.
authors.affiliation: Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave., Suite 208, Memphis, TN 38163, USA.
authors.forename: Elena M
authors.initials: EM
authors.lastname: Paulus
authors.forename: Ben L
authors.initials: BL
authors.lastname: Zarzaur
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Behrman
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology / Q000517:prevention & control; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D004322:Drainage / Q000009:adverse effects / Q000379:methods; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects*; D010185:Pancreatic Fistula / Q000209:etiology / Q000517:prevention & control; D010192:Pancreatic Pseudocyst / Q000209:etiology / Q000517:prevention & control; D010529:Peritoneal Cavity; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D012086:Reoperation; D012189:Retrospective Studies; D013396:Suction; D017211:Treatment Failure