Negative pressure external drainage of the pancreatic duct in pancreaticoduodenectomy.

BACKGROUND/AIMS: Despite the development of surgical techniques, postoperative pancreatic fistula is still one of the main causes of serious morbidity after pancreaticoduodenectomy. Nevertheless numerous studies have been done, studies on preventing pancreatic fistula are lacking. This study is focused on the effectiveness of negative pressure external drainage for pancreaticojejunostomy in pancreaticoduodenectomy patients.

METHODOLOGY

Seventy-six patients were scheduled for pancreaticoduodenectomy at Soonchunhyang University Hospital from January of 2003 to August of 2007. Negative suction drainage group (n = 41) and no negative suction drainage group (n = 35) were compared by patient characteristics, parameters related to operation, and complications.

RESULTS

There were no statistical differences between both groups in patient demographics and parameters related to operation. The complication rates were significantly lower in negative suction drainage group in terms of postoperative bleeding (P = 0.012), choledochojejunostomy leak (P = 0.014), and pancreatic fistula (P = 0.018).

CONCLUSIONS

This retrospective study showed that external stenting with negative pressure suction drainage of the pancreatic duct has significantly reduced the rate of pancreatic fistula in duct-to-mucosa pancreaticojejunostomy with improved surgical outcomes.