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Published in: Updates in Surgery 3/2024

Open Access 25-04-2024 | Pancreatectomy | Original Article

Intraperitoneal prophylactic drain after pancreaticoduodenectomy: an Italian survey

Authors: Claudio Ricci, Nicolò Pecorelli, Alessandro Esposito, Giovanni Capretti, Stefano Partelli, Giovanni Butturini, Ugo Boggi, Alessandro Cucchetti, Alessandro Zerbi, Roberto Salvia, Massimo Falconi, Pan-Drain study group

Published in: Updates in Surgery | Issue 3/2024

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Abstract

Intraperitoneal prophylactic drain (IPD) use in pancreaticoduodenectomy (PD) is still controversial. A survey was designed to investigate surgeons’ use of IPD in PD patients through 23 questions and one clinical vignette. For the clinical scenario, respondents were asked to report their regret of omission and commission regarding the use of IPD elicited on a scale between 0 (no regret) and 100 (maximum regret). The threshold model and a multilevel mixed regression were applied. One hundred three (97.2%) respondents confirmed using at least two IPDs. The median regret due to the omission of IPD was 84 (67–100, IQR). The median regret due to the commission of IPD was 10 (3.5–20, IQR). The CR-POPF probability threshold at which drainage omission was the less regrettable choice was 3% (1–50, IQR). The threshold was lower for those surgeons who performed minimally invasive PD (P = 0.048), adopted late removal (P = 0.002), perceived FRS able to predict the risk (P = 0.006), and IPD able to avoid relaparotomy P = 0.036). Drain management policies after PD remain heterogeneous among surgeons. The regret model suggested that IPD omission could be performed in low-risk patients.
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Metadata
Title
Intraperitoneal prophylactic drain after pancreaticoduodenectomy: an Italian survey
Authors
Claudio Ricci
Nicolò Pecorelli
Alessandro Esposito
Giovanni Capretti
Stefano Partelli
Giovanni Butturini
Ugo Boggi
Alessandro Cucchetti
Alessandro Zerbi
Roberto Salvia
Massimo Falconi
Pan-Drain study group
Publication date
25-04-2024
Publisher
Springer International Publishing
Keyword
Pancreatectomy
Published in
Updates in Surgery / Issue 3/2024
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-024-01836-0

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