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November 19, 2025Annals of Gastroenterological SurgeryOpen Access

Proposal of Early Drain Exchange After Pancreatoduodenectomy From the View of Reducing Postoperative Pancreatic Fistula

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Authors

TSTaihei SomaMYMihoko YamadaRARyo ASHIDA

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Overview

Trial demonstrates that early drain exchange decreases fistula incidence and hospital stay after pancreatoduodenectomy.

Key Points

  • This research aims to evaluate the impact of early drain exchange on reducing postoperative pancreatic fistula after pancreatoduodenectomy.
  • Analyzed 481 patients who underwent pancreatoduodenectomy from 2019 to 2023.
  • Classified patients into early (POD 5 or earlier) and standard (POD 6 or later) drain exchange groups based on amylase levels.
  • Compared incidence of postoperative pancreatic fistula, drain placement duration, and hospital stay between groups.
  • Grade B postoperative pancreatic fistula occurred in 24.3% of patients.
  • Early drain exchange resulted in lower grade B POPF rates (47.3% vs. 73.7%).
  • Drain placement duration was shorter in the early group (21 days vs. 27 days).
  • Hospital stay was also reduced for the early group (23 days vs. 33 days).
  • Multivariate analysis indicated that later drain exchanges were a risk factor for grade B POPF.

Cite This Study

Soma et al. (2025) studied this question.

synapsesocial.com/papers/6924f095c0ce034ddc350bc3https://doi.org/10.1002/ags3.70133
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A modified perioperative strategy including ultrasonic pancreatic transection and early drain removal after pancreatoduodenectomy: a retrospective before-and-after study2026
  2. 2Predictive value of drain fluid amylase level on postoperative day one after pancreatic resection for predicting postoperative pancreatic fistula2024 · 2 citations
  3. 3Management of Postoperative Pancreatic Fistulas After Pancreaticoduodenectomy Using Open Drainage and Negative Pressure Wound Therapy With Instillation and Dwell Times2024 · 1 citations
  4. 4Development of novel criteria for drain removal after pancreaticogastrostomy in pancreaticoduodenectomy: a retrospective analysis and validation study at a single institution2026
  5. 5Clinical Impact of Early Positive Drain Culture on Outcomes and Management After Pancreaticoduodenectomy2026