A new method of performing continuous intraabdominal drainage after pancreaticoduodenectomy

Dehiscence of the pancreaticoenterostomy is one of the most feared, yet common, postoperative complications following pancreaticoduodenectomy (PD). We report herein a new technique we developed for performing continuous intraabdominal suction drainage (CISD) following PD. This method of CISD involves positioning an 18 Fr sump tube beside the pancreaticoenterostomy, with a continuous suction pressure of about -20cmH2O. The fluid obtained from the sump tube is also useful for monitoring amylase levels and providing bacterial cultures to enable the early detection of dehiscence of pancreaticoenterostomy. A study was conducted on 150 patients who underwent PD for periampullary carcinoma over a 20-year period. The patients were divided into two groups according to whether or not CISD was performed: group 1 comprised 71 patients who had CISD, and group 2 79 patients who did not have CISD. Although the frequency of anastomotic dehiscence did not differ between the two groups (32% in group 1 and 25% in group 2), the mortality rate of the patients with anastomotic leakage in group 1 was lower than that in group 2 (P = 0.07). Thus, we believe that our new technique for performing CISD could improve the surgical outcome of patients following PD.