{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T16:18:31Z","timestamp":1771863511350,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T00:00:00Z","timestamp":1603065600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Prophylactic drainage following pancreaticoduodenectomy (PD) reduces morbidity and mortality. Little evidence exists to advise on whether passive gravity (PG) or active suction (AS) drainage systems result in superior outcomes. This study examines the relationship between drainage system and morbidity following PD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients undergoing elective PD with an operatively placed drain in the 2016 ACS\u2010NSQIP database were included. Pre\u2010 and intra\u2010operative factors were examined. Multivariable logistic regression and coarsened exact matching (CEM) were used to assess for an association between drainage system (PG vs. AS) and morbidity. The primary outcome was postoperative pancreatic fistula (POPF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 3430 patients were included: 563 (16.4%) with PG and 2867 (83.6%) with AS drainage system. On multivariable regression, 1787 patients were included. Drainage type was not associated with POPF, surgical site infection, delayed gastric emptying, or re\u2010operation. AS drainage was protective against percutaneous drain insertion (OR 0.65, 95% CI 0.44\u20130.96, <jats:italic>p<\/jats:italic>\u2009=\u20090.033). In the CEM cohort (<jats:italic>n<\/jats:italic>\u2009=\u2009268), superficial SSI was higher in the AS group (0.8% vs. 6.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.036). There was a trend toward higher rates of composite total SSI (PG 15.7%, AS 23.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.092) and organ space SSI (PG 14.2%, AS 20.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.195) in the AS group; this did not demonstrate statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The findings of this study suggest that AS drainage is protective against percutaneous drain insertion, but may be associated with increased risk of SSI. There was no relation between drainage type and POPF. A prospective, randomized controlled trial is warranted to further explore these findings.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05823-5","type":"journal-article","created":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T17:03:03Z","timestamp":1603126983000},"page":"554-561","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Passive Versus Active Intra\u2010Abdominal Drainage Following Pancreaticoduodenectomy: A Retrospective Study Using The American College of Surgeons NSQIP Database"],"prefix":"10.1002","volume":"45","author":[{"given":"Madeline","family":"Lemke","sequence":"first","affiliation":[{"name":"School of Medicine Queen's University Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lily","family":"Park","sequence":"additional","affiliation":[{"name":"School of Medicine University of Ottawa Ottawa ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fady K.","family":"Balaa","sequence":"additional","affiliation":[{"name":"School of Medicine University of Ottawa Ottawa ON Canada"},{"name":"Liver and Pancreas Surgical Unit, Division of General Surgery The Ottawa Hospital \u2013 General Campus 501 Smyth Road K1H 8L6 Ottawa ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guillaume","family":"Martel","sequence":"additional","affiliation":[{"name":"School of Medicine University of Ottawa Ottawa ON Canada"},{"name":"Liver and Pancreas Surgical Unit, Division of General Surgery The Ottawa Hospital \u2013 General Campus 501 Smyth Road K1H 8L6 Ottawa ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jad Abou","family":"Khalil","sequence":"additional","affiliation":[{"name":"School of Medicine University of Ottawa Ottawa ON Canada"},{"name":"Liver and Pancreas Surgical Unit, Division of General Surgery The Ottawa Hospital \u2013 General Campus 501 Smyth Road K1H 8L6 Ottawa ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly A.","family":"Bertens","sequence":"additional","affiliation":[{"name":"School of Medicine University of Ottawa Ottawa ON Canada"},{"name":"Liver and Pancreas Surgical Unit, Division of General Surgery The Ottawa Hospital \u2013 General Campus 501 Smyth Road K1H 8L6 Ottawa ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2015.10.028"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.05.001"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.014"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000460"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000524464.85963.61"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001859"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200110000\u201000008"},{"key":"e_1_2_6_9_1","doi-asserted-by":"crossref","unstructured":"PengS ChengY YangC LuJ WuS ZhouR ChengN(2015) Prophylactic abdominal drainage for pancreatic surgery.Cochrane Database Syst Rev.https:\/\/doi.org\/10.1002\/14651858.CD010583.pub2","DOI":"10.1002\/14651858.CD010583.pub3"},{"issue":"10","key":"e_1_2_6_10_1","first-page":"CD010583","article-title":"Prophylactic abdominal drainage for pancreatic surgery","volume":"10","author":"Cheng Y","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_11_1","doi-asserted-by":"crossref","unstructured":"ZhangW HeS ChengY XiaJ LaiM ChengNet al. 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