Wada Seidai, Hatano Etsuro, Yoh Tomoaki, Seo Satoru, Taura Kojiro, Yasuchika Kentaro, Okajima Hideaki, Kaido Toshimi, Uemoto Shinji
Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
Surg Today. 2017 Jun;47(6):712-717. doi: 10.1007/s00595-016-1432-3. Epub 2016 Oct 24.
Prophylactic abdominal drainage is performed routinely after liver resection in many centers. The aim of this study was to examine the safety and validity of liver resection without abdominal drainage and to clarify whether routine abdominal drainage after liver resection is necessary.
Patients who underwent elective liver resection without bilio-enteric anastomosis between July, 2006 and June, 2012 were divided into two groups, based on whether surgery was performed before or after, we adopted the no-drain strategy. The "former group" comprised 256 patients operated on between July, 2006 and June, 2009 and the "latter group" comprised 218 patients operated between July, 2009 and June, 2012. We compared the postoperative complications, percutaneous drainage, and postoperative hospital stay between the groups, retrospectively.
There were no significant differences in the rates of postoperative bleeding, intraabdominal infection, or bile leakage between the groups. Drain insertion after liver resection did not reduce the rate of percutaneous drainage. Postoperative hospital stay was significantly shorter in the latter group.
Routine abdominal drainage is unnecessary after liver resection without bilio-enteric anastomosis.
在许多中心，肝切除术后常规进行预防性腹腔引流。本研究的目的是探讨不进行腹腔引流的肝切除术的安全性和有效性，并阐明肝切除术后常规腹腔引流是否必要。
将2006年7月至2012年6月期间接受择期肝切除且未行胆肠吻合术的患者，根据手术时间先后分为两组，我们采用了不置引流管策略。“前组”包括2006年7月至2009年6月期间接受手术的256例患者，“后组”包括2009年7月至2012年6月期间接受手术的218例患者。我们回顾性比较了两组患者的术后并发症、经皮引流情况及术后住院时间。
两组患者术后出血、腹腔内感染或胆漏发生率无显著差异。肝切除术后放置引流管并未降低经皮引流率。后组患者的术后住院时间明显缩短。
未行胆肠吻合术的肝切除术后无需常规腹腔引流。
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