The impact of different postoperative drainage strategies on outcomes in pancreaticoduodenectomy:A retrospective multicenter real-world study
XU Lin-wei
CAI Yun-qiang
GAO Song
XU Qiang
CHEN Wei
ZHANG Man
SONG YU-ning
LI Peng-yu
YU Xi
LI Hong-tao
LI Dan
WANG Gang
WEI Ji-shu
JIN Jia-bin
ZHANG Yu-hua
Abstract：Objective To investigate the impact of different postoperative drainage strategies on outcomes following pancreaticoduodenectomy(PD).Methods Clinical data of 116 PD cases admitted to the medical group of high-flow pancreatic surgery centres(annual pancreatic surgery volume ≥50 cases)in eight hospitals in China from October to December 2022 were retrospectively analysed.Patients were divided into two groups based on different drainage strategies:the two-tube group(51 cases with placement of 2 drainage tubes)and the three-tube group(65 cases with placement of 3 drainage tubes).COX regression analysis was used to identify factors influencing postoperative length of hospital stay,and the receiver operating characteristic(ROC)curve was used to determine the optimal cutoff value for prolonged hospitalization.Logistic regression analysis was performed to identify factors influencing prolonged hospitalization after propensity score matching(PSM)of the two groups.Results Three-tube group patients had a shorter postoperative hospital stay compared to two-tube group patients(HR=1.512,P=0.034).Based on ROC curve analysis,postoperative hospital stay＞22 days was defined as prolonged hospitalization.After propensity score matching,there were 32 cases in the two-tube group and the three-tube group,there was no statistically significant difference between groups in prognosis-related indicators,but there is a statistically significant difference in the incidence of prolonged hospitalization[25.0％(8/32)vs.3.1％(1/32),P=0.026];Multivariate regression analysis showed that placement of three drainage tubes was a protective factor for prolonged hospitalization(OR=0.088,P=0.031).Conclusion The number of drains placed when prophylactic drainage is performed in PD patients is associated with prolonged hospitalisation,and more adequate drainage may improve patient outcomes.
Keywords：multicenter studypancreaticoduodenectomydrainagehospitalization time
Publication Date：2024-04-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 441-446 )