• Hiromichi Kawaida, Hiroshi Kono, Hidetake Amemiya, Naohiro Hosomura, Yudai Higuchi, Takashi Nakayama, Isamu Tsukahara, Ryo Saito, Naoki Ashizawa, Yuuki Nakata, Katsutoshi Shoda, Hiroki Shimizu, Shinji Furuya, Hidenori Akaike, Yoshihiko Kawaguchi, Makoto Sudo, Jun Itakura, Hideki Fujii, and Daisuke Ichikawa.
• First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan kawaidah@yamanashi.ac.jp.
• Anticancer Res. 2021 Jan 1; 41 (1): 403-408.

Background/AimDrains are frequently placed at the time of distal pancreatectomy (DP) to evacuate pancreatic juice and intra-abdominal exudate and obtain information on abdominal cavity status. However, the timing of drain removal remains debatable. Meanwhile, prolonged drain placement might increase the risk of postoperative pancreatic fistula (POPF), with a prevalence of 5-40%. Therefore, we examined the effect of removing the drain within postoperative day (POD) 3 on the risk of POPF development.Patients And MethodsA total of 108 consecutive patients who underwent DP between April 2015 and March 2020 were examined and divided into two groups according to the day of drain removal; hence, for some patients, the drain was removed on POD 1 (POD 1 group) and for others on POD 3 (POD 3 group). Furthermore, risk factors, including drain fluid amylase (DFA) levels, for developing POPF were investigated.ResultsThe overall rate of clinically relevant POPF was 4.6% and did not significantly differ between the POD 1 and POD 3 groups [4.5% and 4.9%, respectively (p=0.924)]. DFA levels on POD 1 did not significantly differ between patients with and without POPF. On POD 3 and POD 5, C-reactive protein (CRP) levels were significantly higher in patients with POPF than in those without (p=0.03 and p<0.001, respectively).ConclusionEarly drain removal regardless of DFA level may reduce the risk of developing POPF. CRP measured on POD 3 and POD 5 appeared to be a useful predictor of clinically relevant POPF.Copyright© 2021, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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