title: External Versus Internal Pancreatic Duct Drainage for the Early Efficacy After Pancreaticoduodenectomy: A Retrospectively Comparative Study.
abstract: OBJECTIVE
  To compare the early efficacy of external versus internal pancreatic duct drainage after pancreaticoduodenectomy (PD), providing clinical evidence for selecting the optimal approach to pancreatic duct drainage.
  
  
  METHODS
  The clinical data of 395 consecutive patients undergoing PD from 2006 to 2013 were analyzed retrospectively. All the patients were divided into external and internal drainage group. Intraoperative blood loss, surgery duration, postoperative hospitalization duration, mortality rate, PF, and other complications were compared between the two groups. The perioperative relative risk factors that might induce PF were analyzed.
  
  
  RESULTS
  External drainage significantly reduced the incidences of post-PD PF, delayed gastric emptying, abdominal infection, bowel obstruction, overall complications, and shortened the healing time of PF (p < .05). The univariate analysis showed that the pancreatic duct drainage method, body mass index (BMI), preoperative serum bilirubin level, perioperative blood transfusion, pancreaticojejunostomy approach, pancreatic texture, pancreatic duct diameter, and primary disease differed markedly between the two groups (p < .05). A multivariate analysis revealed that BMI ≥ 25 kg/m(2), internal pancreatic duct drainage, pancreatic duct diameter <3 mm, soft pancreatic texture, and ampullary disease were independent risk factors for PF.
  
  
  CONCLUSIONS
  External pancreatic duct drainage can effectively reduce the morbidity of PF and overall complications after PD.
authors.affiliation: a Department of Pancreatic and Biliary Surgery , The First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
authors.affiliation: a Department of Pancreatic and Biliary Surgery , The First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Le
authors.initials: L
authors.lastname: Li
authors.affiliation: a Department of Pancreatic and Biliary Surgery , The First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: a Department of Pancreatic and Biliary Surgery , The First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Feng-Zhi
authors.initials: FZ
authors.lastname: Qu
authors.affiliation: c Department of Pathology , The First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Hong
authors.initials: H
authors.lastname: Zhu
authors.affiliation: a Department of Pancreatic and Biliary Surgery , The First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Jia-Chen
authors.initials: JC
authors.lastname: Lv
authors.affiliation: b Department of Hygiene and Statistics of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Yue-Hui
authors.initials: YH
authors.lastname: Jia
authors.affiliation: a Department of Pancreatic and Biliary Surgery , The First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Lin-Feng
authors.initials: LF
authors.lastname: Wu
authors.affiliation: a Department of Pancreatic and Biliary Surgery , The First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang Province , China.
authors.forename: Bei
authors.initials: B
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D061646:Operative Time; D010183:Pancreatic Ducts / Q000601:surgery*; D010185:Pancreatic Fistula / Q000453:epidemiology*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: early efficacy; pancreas; pancreatic duct drainage; pancreatic fistula; pancreatic surgery; pancreaticoduodenectomy