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Draining During Liver Surgery Unnecessary, May Cause Complications
SAN DIEGO (May 21, 2016) – Drain use during major liver surgery does nothing to improve overall surgical outcomes and may cause excess complications, according to a study presented at Digestive Disease Week/Society of Surgery of the Alimentary Tract, a major medical conference held in San Diego.
Andreas Karachristos, MD, PhD, FACS, former director of hepatic surgery at Fox Chase Cancer Center and Henry Pitt MD, FACS, Chief Quality Officer TUHS, analyzed 800 hepatectomies that had been recorded in a national database administered by the American College of Surgeons (ACS-NSQIP). Hepatectomies are surgeries used to treat liver cancer, particularly when that cancer has spread from the colon. Of those cases, 519 (65 percent) had used some sort of drain during the surgery while 281 (35 percent) did not.
“These were major academic medical centers and community hospitals that we observed and drain use is common practice” said Karachristos. “However, there is no evidence that it works. In my own practice, I do not routinely use drains after major hepatic surgery because it does not improve outcomes.”
The study showed no different in mortality, surgical site infections, length of hospital stay or readmissions. There was a difference in bile leaks, however, with nearly 8 percent of patients who received drains reporting bile leaks compared to less than 2 percent in the non-drain group.
“A bile leak is not minor. It can cause multiple other problems and in fact bile leak was associated with increased morbidity, sepsis, increased hospital stay and readmissions,” said Karachristos.
The investigators received a "Poster of Distinction" award from the meeting organizers for this presentation.