Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany; CRC 1321 Modelling and Targeting Pancreatic Cancer, Munich, Germany.
Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
Surgery. 2022 Jul;172(1):265-272. doi: 10.1016/j.surg.2021.11.023. Epub 2022 Jan 5.
Drain use in pancreatic surgery remains controversial. This survey sought to evaluate habits, experiences, and opinions of experts in the field on the use of drains to provide interesting insights for pancreatic surgeons worldwide.
An online survey designed via Google Forms was sent in December 2020 to experienced surgeons of the International Study Group for Pancreatic Surgery.
Forty-two surgeons (42/63, 67%) completed the survey. During their career, 74% (31/42) performed personally >500 pancreatic resections; of these, 9 (21%) >1,500. Sixty-nine percent of the respondents (29/42) declared to always use drains during pancreatic resections and 17% (7/42) in >50% of the operations. For these participants, the use of drains does not increase but reduces the risk of pancreatic fistula and other complications, and more importantly, helps to detect them earlier and manage them better. By contrast, 2 surgeons (5%) declared to never apply drains, whereas other 4 (10%) use drains only in selective cases, deeming that drains increase the risk of infection and other complications. When applied, drains are managed very heterogeneously as for the type of drains, enzyme testing, and removal schedules. Four participants declared to practice continuous irrigation. Twenty-two surgeons (55%) remove drains routinely within the third postoperative day, other 11 (27.5%) only in selected cases, whereas 7 (17.5%) normally keep drains longer.
Despite plenty of publications on this topic, drain management in pancreatic surgery remains very heterogeneous. Safety and the surgeon´s personal experience seem to play a determining role.
胰腺手术中引流的使用仍然存在争议。本调查旨在评估该领域专家在引流使用方面的习惯、经验和意见，为全球胰腺外科医生提供有趣的见解。
通过 Google Forms 设计了一份在线调查，并于 2020 年 12 月发送给国际胰腺外科研究组的经验丰富的外科医生。
42 名外科医生（42/63，67%）完成了调查。在他们的职业生涯中，74%（31/42）个人进行了>500 例胰腺切除术；其中 9 例（21%）>1500 例。69%的受访者（29/42）表示在胰腺切除术中始终使用引流管，17%（7/42）在>50%的手术中使用引流管。对于这些参与者来说，引流管的使用不会增加但会降低胰瘘和其他并发症的风险，更重要的是，有助于更早地发现并更好地管理它们。相比之下，2 名外科医生（5%）表示从不使用引流管，而另外 4 名（10%）仅在选择性病例中使用引流管，认为引流管会增加感染和其他并发症的风险。引流管的管理非常多样化，包括引流管的类型、酶检测和移除方案。有 4 名参与者表示实施持续灌洗。22 名外科医生（55%）常规在术后第 3 天内取出引流管，其他 11 名（27.5%）仅在选择性病例中取出，而 7 名（17.5%）通常保留引流管时间更长。
尽管有大量关于这个主题的出版物，但胰腺手术中的引流管理仍然非常多样化。安全性和外科医生的个人经验似乎起着决定性的作用。
