Re-appraisal of prophylactic drainage in uncomplicated liver resections: a systematic review and meta-analysis

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• 作者：Paschalis Gavriilidis¹ ; ² ; Ernest Hidalgo¹ ; Nicola de'Angelis² ; Peter Lodge¹ ; Daniel Azoulay² ; ³ ; ^{daniel.azoulay@hmn.aphp.fr}
• 刊名：HPB
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：19
• 期：1
• 页码：16-20
• 全文大小：405 K
• 卷排序：19

文摘

The benefit of prophylactic drainage after uncomplicated hepatectomy remains controversial. The aim of this study was to update the existing evidence on the role of prophylactic drainage following uncomplicated liver resection.MethodsCochrane, Medline (Pubmed), and Embase were searched. The Medline search strategy was adopted for all other databases. A grey literature search was performed. Meta-analyses were performed with Review Manager 5.3. Primary outcomes were mortality and ascitic leak, secondary outcomes were infected intra-abdominal collection, chest infection, wound infection of the surgical incision, biliary fistula, and length of stay.ResultsThe incidence of ascitic leak was higher in the drained group (Odds Ratio = 3.33 [95% Confidence Interval: 1.66–5.28]). Infected intra-abdominal collections, wound infections, chest infections, biliary fistula, length of stay and mortality were not statistically different between groups.ConclusionsThe routine utilisation of drains after elective uncomplicated liver resection does not translate into a lower incidence of postoperative complications. Therefore, based on the current available evidence, routine abdominal drainage is not recommended in elective uncomplicated hepatectomy.