Application of suction-type cigarette drain in leak-prone hepatopancreatobiliary surgery.

BACKGROUNDS/AIMS: Penrose drain and Jackson-Pratt (JP) drain have benefits and drawbacks in terms of functional reliability of prolonged duration and easiness of bedside management. We have developed a suction-type cigarette drain (SCD) to compensate for the drawbacks.

METHODS

We have used SCDs in leak-prone or contaminated hepatopancreatobiliary surgeries since 2020. Herein, we describe key elements of our 20-year experience with the management of SCDs.

RESULTS

The SCD is available as two-piece and three-piece types. The two-piece SCD is a cigarette drain consisted of a silastic Penrose drain and Jackson-Pratt (JP) drain bearing multiple side holes. The three-piece SCD is a cigarette drain consisted of a silastic Penrose drain, internally located Nelaton catheter with multiple side-holes, and a connecting JP drain tube and bulb. These SCDs were inserted into the abdominal wall with a hemostat clamps and sealed with air-tight ties. Three sets of SCDs were usually inserted in more than 100 cases of patients who underwent pancreatoduodenectomy, and none of them underwent repeat surgery for postoperative pancreatic fistula. In more than 30 patients with extensive abdominal contamination, a single SCD was usually inserted into the high-risk point of fluid collection and none of them underwent repeat surgery to manage collection of abnormal fluid or abscess formation.

CONCLUSIONS

Our experience suggests that SCD is highly reliable and acceptably convenient for clinical application in abdominal drainage.