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Postoperative computed tomography findings predict re-drainage cases after early drain removal in pancreaticoduodenectomy

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Abstract

Purpose

This study aimed to investigate the risk factors for re-drainage in patients with early drain removal after pancreaticoduodenectomy (PD).

Methods

This study retrospectively analyzed 114 patients who underwent PD and prophylactic drain removal on postoperative day (POD) 4 between January 2012 and March 2021. We analyzed the risk factors for re-drainage according to various factors. Peri-pancreaticojejunostomic fluid collection (PFC) index and pancreatic cross-sectional area (CSA) were evaluated using computed tomography on POD 4. The PFC index was calculated by multiplying the length, width, and height at the maximum aspect.

Results

Among the 114 patients, 15 (13%) underwent re-drainage due to postoperative pancreatic fistula. Multivariate analysis identified a PFC index ≥ 8.16 cm3 on POD 4 (odds ratio [OR], 20.40, 95%CI 2.38–174.00; p = 0.006) and pancreatic CSA on POD 4 ≥ 3.65 cm2 (OR, 16.40, 95%CI 1.57–171.00; p = 0.020) as independent risk factors for re-drainage.

Conclusion

A careful decision might be necessary for early drain removal in patients with a PFC index ≥ 8.16 cm3 and pancreatic CSA ≥ 3.65 cm2.

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Data availability

The data that support the findings of this study are available from the corresponding author, HM, upon reasonable request.

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Author information

Authors and Affiliations

  1. Department of Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga, 520-2192, Japan

    Nobuhito Nitta, Hiromitsu Maehira, Hajime Ishikawa, Hiroya Iida, Haruki Mori, Takeru Maekawa, Katsushi Takebayashi, Sachiko Kaida, Toru Miyake & Masaji Tani

Authors
  1. Nobuhito Nitta
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  2. Hiromitsu Maehira
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  3. Hajime Ishikawa
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  4. Hiroya Iida
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  5. Haruki Mori
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  6. Takeru Maekawa
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  7. Katsushi Takebayashi
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  8. Sachiko Kaida
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  9. Toru Miyake
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  10. Masaji Tani
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Contributions

Study conception and design were performed by Nobuhito Nitta and Hiromitsu Maehira. The first draft of the manuscript was written by Nobuhito Nitta. Masaji Tani and Hiromitsu Maehira commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hiromitsu Maehira.

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Nitta, N., Maehira, H., Ishikawa, H. et al. Postoperative computed tomography findings predict re-drainage cases after early drain removal in pancreaticoduodenectomy. Langenbecks Arch Surg 408, 427 (2023). https://doi.org/10.1007/s00423-023-03165-z

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  • DOI: https://doi.org/10.1007/s00423-023-03165-z

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