Outpatient Drainmanagement of patients with clinically relevant Postoperative Pancreatic Fistula (POPF)

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

Abstract

PURPOSE: Postoperative pancreatic fistula (POPF) is a common complication after pancreatic surgery associated with extended hospitalization, increased medical costs, and reduced quality of life. The aim of the present study was to analyze the feasibility of ambulatory drainage and develop an ambulatory management algorithm.

METHODS: Patients with POPF grade B or C (according to the ISGPF classification) between Jan. 2005 and Dec. 2014 that required persistent drainage were identified from a prospectively collected database. Postoperative events and clinical outcomes were retrospectively analyzed.

RESULTS: A total of 132 out of 887 patients (14.8%) developed a POPF (grade B or C), and 45 (34.1%) were discharged from the hospital with percutaneous drainage. For patients with grade B fistulas, the mean hospital stay was significantly shorter compared to patients with grade C fistulas (mean 27.7 vs. 40 days; p = 0.0285). About 40% of patients with ambulatory drainage developed a complication, but only 28.9% required readmission. Of those, 52.9% did not require specific treatment and 26.3% were treated with a new drain placement. None of the patients developed major complications, and there was no difference in the frequency of complications between the two groups (p = 0.872). The duration of drain persistence was significantly shorter for patients with grade B fistulas than for those with grade C fistulas (52.2 vs. 85.9 days; p = 0.0007).

CONCLUSIONS: Ambulatory drainage management is feasible in selected patients. No severe complications occurred during ambulatory drainage management. A management algorithm is recommended as this could possibly reduce medical costs and improve quality of life.

Details

OriginalspracheEnglisch
Seiten (von - bis)821-829
Seitenumfang9
FachzeitschriftLangenbeck's Archives of Surgery
Jahrgang402
Ausgabenummer5
PublikationsstatusVeröffentlicht - Aug. 2017
Peer-Review-StatusJa

Externe IDs

Scopus 85020435216
PubMed 28597036

Schlagworte

Schlagwörter

  • Adult, Aged, Aged, 80 and over, Ambulatory Care, Drainage/methods, Female, Humans, Length of Stay/statistics & numerical data, Male, Middle Aged, Pancreatic Diseases/surgery, Pancreatic Fistula/surgery, Postoperative Complications/surgery, Quality of Life, Retrospective Studies, Risk Factors