Prophylactic intra-peritoneal drain placement following pancreaticoduodenectomy: A systematic review and meta-analysis

Table 4 Summary results of drain vs no drain after pancreaticoduodenectomy

	Outcome	Studies (n)	Patients (n)	OR (95%CI)	P	Heterogeneity
						P	I2
All studies	Overall complications	4	989	0.62 (0.48-0.82)	< 0.01	0.39	1%
	Major complications	5	1728	0.75 (0.60-0.93)	0.01	0.11	47%
	Postoperative pancreatic fistula	5	1728	0.61 (0.33-1.12)	0.11	0.03	63%
	Biliary fistula	2	191	0.32 (0.03-3.14)	0.33	NA	NA
	Delayed gastric emptying	2	191	1.85 (0.94-3.62)	0.07	0.70	0%
	Intra-abdominal abscess formation	3	280	1.80 (0.82-3.97)	0.14	0.19	40%
	Post-pancreatectomy hemorrhage	2	191	1.55 (0.60-3.99)	0.36	0.63	0%
	Mortality	4	1639	2.32 (1.11-4.85)	0.02	0.33	12%
	Reoperation	5	1728	1.26 (0.73-2.17)	0.41	0.51	0%
	Readmission	4	1639	0.77 (0.60-0.98)	0.04	0.56	0%
	Radiologic-guided drains	5	1728	0.98 (0.57-1.66)	0.93	0.13	43%
ISGPF definition	Overall complications	3	900	0.61 (0.46-0.81)	< 0.01	0.26	26%
	Major complications	3	900	0.82 (0.34-1.98)	0.66	0.02	74%
	Postoperative pancreatic fistula (ISGPF B/C)	3	900	0.61 (0.14-2.66)	0.51	0.01	81%
	Intra-abdominal abscess formation	2	191	2.57 (1.05-6.29)	0.04	0.49	0%
	Mortality	3	900	1.68 (0.68-4.18)	0.26	0.40	0%
	Reoperation	3	900	1.16 (0.64-2.09)	0.63	0.36	3%
	Readmission	3	900	0.89 (0.62-1.27)	0.52	0.61	0%
	Radiologic-guided drains	3	900	1.34 (0.43-4.19)	0.61	0.05	66%
Quality score ≥ 2	Major complications	2	876	1.08 (0.47-2.46)	0.85	0.03	78%
	Postoperative pancreatic fistula (ISGPF B/C)	2	876	1.02 (0.26-4.00)	0.98	0.01	86%
	Mortality	2	876	4.88 (1.52-15.69)	0.01	0.61	0%
	Reoperation	2	876	2.10 (0.62-7.12)	0.23	0.42	0%
	Readmission	2	876	0.68 (0.50-0.93)	0.02	0.99	0%
	Radiologic-guided drains	2	876	1.42 (0.36-5.66)	0.62	0.01	85%

ISGPF: International Study Group on Pancreatic Fistula; OR: Odds ratio.