An audit of results of a no-drainage practice policy after hepatectomy Journal Article

Authors: Burt, B. M.; Brown, K.; Jarnagin, W.; DeMatteo, R.; Blumgart, L. H.; Fong, Y.
Article Title: An audit of results of a no-drainage practice policy after hepatectomy
Abstract: Background: It was hypothesized that routine operative drainage is unnecessary for elective hepatic resection. Methods: A review was made of the clinical records of patients undergoing liver resection at a tertiary referral hepatobiliary surgery center since the conclusion in April of 1994 of our previous randomized drainage trial. The main outcome measures were operative drainage versus no operative drainage assessed for possible association with diagnoses, extent of hepatectomy, hospital course, and postoperative radiologic percutaneous drainage procedures. Results: Of 1,165 patients, 184 were operatively drained with closed drains according to specific practice criteria and 981 were not subject to operative drainage. Patients who were not operatively drained had length of stay (10.1 days), mortality (2%), and complication rate (34%) comparable with the nondrained patients in the previous randomized trial. Ten percent of these patients required postoperative percutaneous drainage. Patients who were operatively drained were a group who were at higher risk for biliary leakage or infections and consequently had a significantly longer hospital stay, greater mortality, higher complication rate, and required a greater number of percutaneous abdominal drainages. Conclusions: The 84% of patients not operatively drained had no greater adverse outcome. After hepatic resection, routine drainage of the abdomen is unnecessary. © 2002 Excerpta Medica Inc. All rights reserved.
Keywords: adult; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; surgical technique; retrospective studies; major clinical study; mortality; postoperative period; liver neoplasms; clinical practice; risk factor; postoperative complication; postoperative complications; health care policy; length of stay; hospitalization; radiology; diagnostic value; randomized controlled trials; bile leakage; medical record; liver resection; outcomes research; postoperative infection; surgical drainage; hepatectomy; randomization; percutaneous drainage; drainage; medical audit; humans; human; male; female; priority journal; article; operative drainage
Journal Title: American Journal of Surgery
Volume: 184
Issue: 5
ISSN: 0002-9610
Publisher: Elsevier Inc.  
Date Published: 2002-11-01
Start Page: 441
End Page: 445
Language: English
DOI: 10.1016/s0002-9610(02)00998-4
PUBMED: 12433610
PROVIDER: scopus
Notes: Export Date: 14 November 2014 -- Source: Scopus
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MSK Authors
  1. Leslie H Blumgart
    344 Blumgart
  2. Ronald P DeMatteo
    610 DeMatteo
  3. Bryan M Burt
    18 Burt
  4. William R Jarnagin
    600 Jarnagin
  5. Yuman Fong
    746 Fong
  6. Karen T Brown
    165 Brown