A Clinical Study on the Management of Drainage after Hepatic Resection

Masataka Ikeda, Mitsukazu Gotoh, Hiroaki Nagano, Masato Sakon, Toshio Kanai, Koji Umeshita, Yasunori Hasuike, Morito Monden

Department of Surgery II, Osaka University Medical School

In order to clarify the role of intraabdominal drains after hepatic resection, 54 patients who underwent hepatectomy were analyzed based on drainage-tube-related complications and duration of hospital stay. The patients were divided into two groups. In group A (n=29), drains were shortened with the decrease in drainage, and kept in place until the drainage became serous. In group B (n=25), drains were removed immediately when complications such as biliary leakage, bleeding and intractable ascites were not demonstrated. The duration of drainage and the postoperative hospital stay of the patients who were free of complications were significantly shorter in group B (n=19) than in group A (n=17) (8.7 ± 2.5 vs 14.8 ± 6.7 p<0.001, 15.6 ± 2.8 vs 24.8 ± 10.4 p<0.001, respectively), although none of the parameters was significantly different between the patients who had complications in group A (n=12) and group B (n=6). Early removal of abdominal drains in group B patients, when performed according to the criteria described above, did not cause any adverse effect on the patient's clinical course. These results indicate that early removal of abdominal drains significantly reduces the postoperative hospital stay of patients undergoing hepatectomy without causing any adverse effect, when the patients are secured from the complications of biliary leakage, bleeding and intractable ascites.

Key words
postoperative drainage after hepatic resection, open and closed drainage system, postoperative hospital stay after hepatic resection, bacterial translocation after hepatic resection

Reprint requests
Masato Sakon Department of Surgery II, Osaka University, Medical School
2-2 Yamadaoka, Suita, 565 JAPAN

Accepted
May 17, 1995

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