Incidence and outcomes of postoperative fluid collections after minimally invasive distal pancreatectomy without placement of surgical drain. A prospective observational cohort study

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-03-22 DOI:10.1002/jhbp.1423
Núria Lluís, Filipe Kunzler, Domenech Asbun, Ramon E. Jimenez, Horacio J. Asbun
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Abstract

Background/Purpose

There is uncertainty about the role of prophylactic intra-abdominal drains after distal pancreatectomy. In the present study, we aimed to describe the long-term outcomes of postoperative pancreatic collections in patients who underwent a minimally invasive distal pancreatectomy (MIDP) without surgical drain placement.

Methods

From 2018 to 2022, consecutive patients who underwent a MIDP were recorded. Patients were followed at 90 days, 6 months, and in the long term. The use of interventional procedures and antibiotic therapy were documented, and the overall evolution of the collections was assessed.

Results

A total of 91 patients underwent MIDP; 11 were excluded; 80 were analyzed. Median age was 63 (51–73) years; 61.3% were women. Most lesions (71.3%) were malignant; 15 patients received neoadjuvant therapy. Procedures were laparoscopic (87.5%) or robotic (12.5%). Incidence of postoperative pancreatic collections was 33%; 10 patients were symptomatic. Interventional endoscopic (n = 3) or percutaneous (n = 3) procedures were required. At a follow-up of 24 (17.5–33.1) months, 18 collections resolved completely, eight partially, and one increased.

Conclusions

Patients who undergo MIDP without surgical drain placement develop well-tolerated pancreatic collections. Although a minority may require endoscopic or percutaneous drainage, the majority can be managed conservatively and resolve spontaneously in the long term.

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不放置手术引流管的微创胰腺远端切除术后积液的发生率和预后。前瞻性观察队列研究。
背景/目的:远端胰腺切除术后预防性腹腔内引流的作用尚不确定。在本研究中,我们旨在描述接受微创远端胰腺切除术(MIDP)而未放置手术引流管的患者术后胰腺积液的长期预后:从2018年到2022年,记录了连续接受MIDP的患者。对患者进行了 90 天、6 个月和长期随访。记录了介入手术和抗生素治疗的使用情况,并评估了收集的总体演变情况:共有 91 名患者接受了 MIDP,其中 11 人被排除在外,80 人接受了分析。中位年龄为63(51-73)岁;61.3%为女性。大多数病变(71.3%)为恶性;15名患者接受了新辅助治疗。手术方式为腹腔镜(87.5%)或机器人(12.5%)。术后胰腺积液发生率为33%;10名患者出现症状。需要进行介入内镜手术(3 例)或经皮手术(3 例)。随访24(17.5-33.1)个月后,18例胰腺积液完全消退,8例部分消退,1例增加:结论:接受 MIDP 而不进行外科引流管置入术的患者可以很好地耐受胰腺积液。虽然少数患者可能需要内镜或经皮引流,但大多数患者可以采取保守治疗,并在长期内自行消退。
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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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