title: The safety of the early removal of prophylactic drainage after liver resection based solely on predetermined criteria: a propensity score analysis.
abstract: Prophylactic drainage after liver resection remains a common practice amongst hepatic surgeons. However, there is little information about the optimal timing of drain removal.
  
  
  
  From April 2008 to December 2012 (conventional group), the drains were removed based on the treating surgeon's view. From January 2013 to April 2016 (ERP group), the drains were removed on POD 3 if the bile concentration of the drain discharge was less than three times the serum bilirubin on POD 3, and the amount of drain discharge was <500 ml on POD 3. The postoperative outcomes of the two groups were compared using one-to-one propensity score-matching analysis.
  
  
  
  One hundred nine patients were extracted from ERP group (n = 226) and conventional group (n = 246). The time to drain removal was significantly shorter in the ERP group than in the conventional group (3 days vs. 5 days, P < 0.001). The frequency of delayed bile leakage or the appearance of symptomatic abdominal fluid collection after drain removal did not differ between the two groups (3% vs. 4%, P = 0.791).
  
  
  
  Drain removal on POD 3 based on the volume and bile concentration is safe.
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hokuto
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan. Electronic address: t.nomi45@gmail.com.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nomi
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.
authors.forename: Chihiro
authors.initials: C
authors.lastname: Kawaguchi
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Ishioka
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Obara
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara-shi, 634-8522 Nara, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Kanehiro
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000378:metabolism; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D016208:Databases, Factual; D020878:Device Removal / Q000009:adverse effects; D004322:Drainage / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis / Q000517:prevention & control*; D057216:Propensity Score; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001663:Bilirubin