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Drainage after elective hepatic resection. A randomized trial

J Belghiti1, M Kabbej, A Sauvanet

  • 1Department of Digestive Surgery, University of Paris VII, Hôpital Beaujon, Clichy-Paris, France.

Annals of Surgery
|December 1, 1993
PubMed
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For minor liver resections, avoiding closed-suction drainage reduces postoperative complications. Major liver resections can be performed safely with or without drainage.

Area of Science:

  • Hepatobiliary Surgery
  • Surgical Oncology
  • Abdominal Surgery

Background:

  • Routine surgical drainage is increasingly questioned for intra-abdominal procedures.
  • Evidence is needed regarding the necessity of drainage after hepatic resection.

Purpose of the Study:

  • To evaluate the impact of closed-suction drainage on postoperative complications following elective liver resection.
  • To compare outcomes between patients with and without drainage after hepatic surgery.

Main Methods:

  • A prospective randomized study involving 81 patients undergoing elective hepatic resection.
  • Patients were assigned to either a nondrainage group (n=39) or a closed-suction drainage group (n=42).
  • All fluid collections were monitored via ultrasonography and cultured within five days post-surgery.

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Main Results:

  • The drainage group showed a significantly higher incidence of subphrenic collections (36% vs. 15%) and more frequent infections.
  • Post-major liver resection, complication rates were similar between drainage and nondrainage groups.
  • Mortality was one patient in each group.

Conclusions:

  • Minor liver resections appear safer without the use of closed-suction drainage.
  • Abdominal drainage is not essential for major liver resections, offering flexibility in surgical management.