| アブストラクト | AIM: Although randomized trials have discouraged routine prophylactic abdominal drainage after uncomplicated hepatectomy, these drains are still widely used in clinical practice. This study evaluated the association between prophylactic abdominal drain placement and short-term outcomes after hepatic resection using a nationwide inpatient database. METHODS: We identified patients who underwent initial hepatic resection for liver tumors from the Japanese Diagnosis Procedure Combination database. Patients were classified into drain and no-drain groups according to whether a prophylactic abdominal drain was placed intraoperatively. In-hospital outcomes were compared using propensity score overlap weighting. Subgroup analyses were performed for intra-abdominal infection and in-hospital mortality. RESULTS: Among 73 613 eligible patients, 62 934 (85.5%) received prophylactic abdominal drains. After overlap weighting, the incidence of intra-abdominal infection did not differ significantly between the drain and no-drain groups (5.1% vs. 5.5%; risk difference, -0.3%; 95% confidence interval [CI], -0.8 to 0.1). Bile leakage, postoperative transfusion, postoperative drainage, and hospitalization costs were also comparable between groups. In contrast, prophylactic drain placement was associated with lower in-hospital mortality (0.5% vs. 1.0%; risk difference, -0.6%; 95% CI, -0.8 to -0.4). Subgroup analyses showed that this association was more evident in patients with low body mass index and those treated at low- or middle-volume hospitals. CONCLUSION: Prophylactic abdominal drain placement after hepatic resection was not associated with a lower incidence of intra-abdominal infection. |
|---|
| ジャーナル名 | Annals of gastroenterological surgery |
|---|
| Pubmed追加日 | 2026/10/22 |
|---|
| 投稿者 | Kouzu, Keita; Aso, Shotaro; Hirano, Yuki; Matsui, Hiroki; Yoshimura, Kensuke; Kitagawa, Hiroki; Kato, Toru; Yamane, Naoki; Hagiwara, Osahiko; Miyoshi, Norikatsu; Matsuda, Satoru; Maruyama, Hiroshi; Morikane, Keita; Sasaki, Junichi; Yasunaga, Hideo; Kitagawa, Yuko; Watanabe, Manabu; Tsujimoto, Hironori |
|---|
| 組織名 | Department of Surgery National Defense Medical College Saitama Japan.;Department of Health Services Research, Graduate School of Medicine The;University of Tokyo Tokyo Japan.;Department of Hepatobiliary-Pancreatic and Gastrointestinal Surgery International;University of Health and Welfare School of Medicine Chiba Japan.;Department of Clinical Epidemiology and Health Economics, School of Public Health;The University of Tokyo Tokyo Japan.;Center for Next Generation of Community Health Chiba University Hospital Chiba;Japan.;Department of Infectious Diseases Hiroshima University Hospital Hiroshima Japan.;Department of Surgery, Division of Gastroenterological Surgery Sapporo Medical;University Sapporo Japan.;Department of Cardiovascular Surgery Kawasaki Medical School Okayama Japan.;Department of Surgery Toho University Ohashi Medical Center Tokyo Japan.;Department of Gastroenterological Surgery, Graduate School of Medicine The;University of Osaka Osaka Japan.;Department of Surgery Keio University School of Medicine Tokyo Japan.;Department of Surgery Nippon Medical School Tama Nagayama Hospital Tokyo Japan.;Division of Clinical Laboratory and Infection Control Yamagata University;Hospital Yamagata Japan.;Department of Emergency and Critical Care Medicine Keio University School of;Medicine Tokyo Japan. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42903240/ |
|---|
