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Updated: Jul 11, 2025
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Postoperative computed tomography findings predict re-drainage cases after early drain removal in
Nobuhito Nitta1, Hiromitsu Maehira2, Hajime Ishikawa1
1Department of Surgery, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga, 520-2192, Japan.
Purpose:
This study aimed to investigate the risk factors for re-drainage in patients with early drain removal after pancreaticoduodenectomy (PD).
Methods:
This study retrospectively analyzed 114 patients who underwent PD and prophylactic drain removal on postoperative day (POD) 4 between January 2012 and March 2021. We analyzed the risk factors for re-drainage according to various factors. Peri-pancreaticojejunostomic fluid collection (PFC) index and pancreatic cross-sectional area (CSA) were evaluated using computed tomography on POD 4. The PFC index was calculated by multiplying the length, width, and height at the maximum aspect.
Results:
Among the 114 patients, 15 (13%) underwent re-drainage due to postoperative pancreatic fistula. Multivariate analysis identified a PFC index ≥ 8.16 cm3 on POD 4 (odds ratio [OR], 20.40, 95%CI 2.38-174.00; p = 0.006) and pancreatic CSA on POD 4 ≥ 3.65 cm2 (OR, 16.40, 95%CI 1.57-171.00; p = 0.020) as independent risk factors for re-drainage.
Conclusion:
A careful decision might be necessary for early drain removal in patients with a PFC index ≥ 8.16 cm3 and pancreatic CSA ≥ 3.65 cm2.
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