An audit of results of a no-drainage practice policy after hepatectomy.

Abstract:

BACKGROUND:It was hypothesized that routine operative drainage is unnecessary for elective hepatic resection. METHODS:A review was made of the clinical records of patients undergoing liver resection at a tertiary referral hepatobiliary surgery center since the conclusion in April of 1994 of our previous randomized drainage trial. The main outcome measures were operative drainage versus no operative drainage assessed for possible association with diagnoses, extent of hepatectomy, hospital course, and postoperative radiologic percutaneous drainage procedures. RESULTS:Of 1,165 patients, 184 were operatively drained with closed drains according to specific practice criteria and 981 were not subject to operative drainage. Patients who were not operatively drained had length of stay (10.1 days), mortality (2%), and complication rate (34%) comparable with the nondrained patients in the previous randomized trial. Ten percent of these patients required postoperative percutaneous drainage. Patients who were operatively drained were a group who were at higher risk for biliary leakage or infections and consequently had a significantly longer hospital stay, greater mortality, higher complication rate, and required a greater number of percutaneous abdominal drainages. CONCLUSIONS:The 84% of patients not operatively drained had no greater adverse outcome. After hepatic resection, routine drainage of the abdomen is unnecessary.

journal_name

Am J Surg

authors

Burt BM,Brown K,Jarnagin W,DeMatteo R,Blumgart LH,Fong Y

doi

10.1016/s0002-9610(02)00998-4

subject

Has Abstract

pub_date

2002-11-01 00:00:00

pages

441-5

issue

5

eissn

0002-9610

issn

1879-1883

pii

S0002961002009984

journal_volume

184

pub_type

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