Is routine drainage necessary after pancreaticoduodenectomy?

Table 1 Citations of routine drainage studies

Preference	Ref.	Country	Study design	n	PD
Removed early	Kawai et al[60], 2006	Japan	Time cohort	104	104
Selective routine drainage	Jeekel et al[73], 1992	Netherlands	Prospective case report	22	22
	Heslin et al[74], 1998	United States	Retrospective	89	89
	Lim et al[72], 2013	France	Case-control analysis	54	54
	Mehta et al[93], 2013	United States	Retrospective	709	709
	Correa-Gallego et al[75], 2013	United States	Retrospective	1122	739
No routine drainage	Van Buren et al[79], 2013	United States	Randomized prospective	137	137

Table 2 Studies comparing selective routine drainage with selective no-drainage n (%)

Ref.	Patients	Drain	No drain	Pancreatic fistula			Complications			Possible reasons for drainage
				Drain	No drain	P value	Drain	No drain	P value
Heslin et al[74]	89	51	38	3 (6)	1 (3)	0.30	23 (45)	15 (39)	0.60	Anesthesia time
Lim et al[72]	54	27	27	6 (22)	0 (0)	0.009	13 (48)	6 (22)	0.09	Hard pancreas and dilated main pancreatic duct
Mehta et al[93]	709	251	458	61 (24)	48 (11)	< 0.0001	171 (68)	248 (54)	< 0.0001	Operation type and blood loss
Correa-Gallego et al[75]	739	386	353	104 (27)	59 (17)	0.001	NA	NA	NA	Bile duct diameter, blood loss, and operation time

NA: Not available.