Evidence-based value of prophylactic intraperitoneal drainage following pancreatic resection: a meta-analysis

Abstract

Background and objective: Prophylactic intraperitoneal drainage is usually indwelled after abdominal operation. This study assessed whether prophylactic intraperitoneal drainage was of value after pancreatic resection.

Methods: A systematic literature search was performed to identify relevant articles. Data aggregation and analysis were performed using RevMan 5.0 software package.

Results: A randomized controlled trial and seven observational cohort studies including a total of 2690 patients were eligible. The overall and major complication rates and the occurrence of pancreatic fistula in patients with drainage were higher than those without drainage. Prophylactic intraperitoneal drainage was not associated with a statistically significant reduction in the need for percutaneous drainage, reoperation and readmission, or with an increase in mortality.

Conclusion: The present meta-analysis demonstrated that prophylactic intraperitoneal drainage after pancreatic resection appears to be unable to improve the postoperative course, and may be associated with more severe and higher rate of complication and increased pancreatic fistula occurrence. There is a serious bias in the criteria to insert drain or not in these retrospective studies. Therefore these results should be confirmed by randomized controlled trial.

Keywords: Intraperitoneal drainage; Meta-analysis; Operative outcome; Pancreatic fistula; Pancreatic resection; Postoperative complications.