Association of gravity drainage and complications following Whipple: an analysis of the ACS-NSQIP targeted database

Abstract Background The optimal type of operative drainage following pancreaticoduodenectomy (PD) remains unclear. Our objective is to investigate risk associated with closed techniques (passive [gravity] vs. suction) after PD. Methods We assessed utilized in patients undergoing PD the ACS-NSQIP pancreas-targeted database from 2016 2018. Using multivariable logistic regression adjust for characteristics patient, procedure, and pancreas, we examined association between use gravity postoperative outcomes. Results identified 9665 drains 2018, which 12.7% received drainage. 61.0% had a diagnosis adenocarcinoma or pancreatitis, 26.5% duct <3 mm, 43.5% soft intermediate gland. After adjustment, was decreased rates pancreatic fistula (odds ratio [OR] 0.779, 95% confidence interval [CI] 0.653–0.930, p =0.006), delayed gastric emptying (OR 0.830, CI 0.693–0.988, =0.036), superficial SSI 0.741, 0.572–0.959, =0.023), organ space 0.791, 0.658–0.951, =0.012), readmission 0.807, 0.679–0.958, =0.014) Conclusions Gravity independently CR-POPF, DGE, SSI, Additional prospective research necessary better understand preferred technique