Prophylactic intra-peritoneal drain placement following pancreaticoduodenectomy:A systematic review and metaanalysis

作     者：Yi-Chao Wang Peter Szatmary Jing-Qiang Zhu Jun-Jie Xiong Wei Huang Ilias Gomatos Quentin M Nunes Robert Sutton Xu-Bao Liu 

作者机构：Department of Thyroid and Breast Surgery West China Hospital Sichuan University NIHR Liverpool Pancreas Biomedical Research Unit Royal Liverpool University Hospital University of Liverpool Department of Pancreatic Surgery West China Hospital Sichuan University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第8期

页      面：2510-2521页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：National Institute for Health Research [ACF-2007-07-001  CL-2014-07-001  ACF-2009-07-002] Funding Source: researchfish 

主　　题：Pancreaticoduodenectomy Drain Metaanalysis Morbidi 

摘      要：AIM:To conduct a meta-analysis comparing outcomes after pancreaticoduodenectomy(PD)with or without prophylactic ***:Relevant comparative randomized and nonrandomized studies were systemically searched based on specific inclusion and exclusion *** outcomes were compared between patients with and those without routine *** odds ratios(OR)with 95%CI were calculated using either fixed effects or random effects ***:One randomized controlled trial and four non-randomized comparative studies recruiting 1728patients were *** without prophylactic drainage after PD had significantly higher mortality(OR=2.32,95%CI:1.11-4.85;P=0.02),despite the fact that they were associated with fewer overall complications(OR=0.62,95%CI:0.48-0.82;P=0.00),major complications(OR=0.75,95%CI:0.60-0.93;P=0.01)and readmissions(OR=0.77,95%CI:0.60-0.98;P=0.04).There were no significant differences in the rates of pancreatic fistula,intraabdominal abscesses,postpancreatectomy hemorrhage,biliary fistula,delayed gastric emptying,reoperation or radiologic-guided drains between the two ***:Indiscriminate abandonment of intraabdominal drainage following PD is associated with greater mortality,but lower complication *** randomized trials should compare routine vs selective drainage.