Impact of abdominal drainage systems on postoperative complication rates following liver transplantation

Abstract

BackgroundDepending on the extent of surgery, coagulation status and the number of anastomoses, drains are routinely used during liver transplantation. The aim of this study was to compare different drain types with regard to abdominal complication rates.MethodsAll consecutive full-size orthotopic liver transplantations (LTX) performed over a 7-year period were included in this retrospective analysis. Abdominal drain groups were divided into open-circuit drains and closed-circuit drains. Data are reported as total number (%) or median (range); for all comparisons a p value <0.05 was considered statistically significant.ResultsA total of 256 LTX [age 56.89 (0.30–75.21) years; MELD 14.5 (7–40)] was included; 56 (21.8 %) patients received an open-circuit Easy Flow Drain (Group 1) and 200 (78.2 %) a closed-circuit Robinson Drainage System (Group 2). For Groups 1 and 2, overall infection rates were 78.6 and 56 % (p = 0.001), abdominal infection rates 50.82 and 21.92 % (p = 0.001), yeast infection rates 37 and 23 % (p = 0.02), abdominal bleeding rates 26.78 and 17 % (p = 0.07), biliary complication rates 14.28 and 13.5 % (p = 0.51), respectively.ConclusionsIn this retrospective series, open-circuit drains were associated with more abdominal complications, mainly due to intraabdominal infections, than were closed-circuit drains.

An agent to improve gastrointestinal recovery after laparoscopy cholecystectomy: Nicotine gum

“…When the literature is reviewed, it has been seen that drain use increased the abdominal inflammation and secondary to that, complications occurred. [26,27] As a conclusion of our study, we think that intra-abdominal drain triggered the inflammatory process and negatively affected the recovery of the gastrointestinal system.…”

The role of T‐tubes and abdominal drains on short‐term outcomes in liver transplantation – A systematic review of the literature and expert panel recommendations

“…This study also showed more infectious complications when drains were used 3 . It was suggested by Weiss and colleagues not to use open‐circuit drains, as these drains were associated with significantly more intra‐abdominal infections 4 . The question remains if the benefits of abdominal drains (i.e., early detection of postoperative complications) outweigh their risks (i.e., intra‐abdominal infections and potential overtreatment of “subclinical” biliary leaks or infections).…”

“…Others believe that they are not as useful and only serve to increase potential risk for infection and may even be a reason for increased length of stay post-transplant. [1][2][3][4][5][6] A similar argument and debate is made over the use of T-tubes. It is well known that biliary complications are still a major cause of long-term morbidity after LT. [7][8][9][10] In addition to technical and vascular issues leading to biliary complications, surgeons have debated whether or not using a T-tube is contributing to or reducing the occurrence of these complications.…”

Automation of Postoperative Surgical Drain Monitoring with Novel Biosensing Technology: Proof of Concept in a Peritoneal Injury Model

“…The current SOC for surgical drain monitoring is manual, and despite the necessity of surgical drains, there is a significant risk of complication and inadequate temporal detection of these events. 5 The drain monitoring process has previously been examined for ways to improve, 4 as studies have underscored how burdensome complications may be. 2 Moreover, increased risk of infection has been attributed to longer length of stay with a surgical drain.…”