OBJECTIVE This systematic review and meta-analysis aimed to compare outcomes between abdominal drain placement and no drain placement post-pancreatectomy. BACKGROUND Left pancreatectomy (LP) is a surgical procedure commonly employed for various pancreatic conditions, often associated with postoperative complications like post-operative pancreatic fistula (POPF). While routine abdominal drainage following LP has been standard practice, recent evidence suggests potential benefits of omitting this approach. METHODS A comprehensive search was conducted on PubMed, Cochrane, and Embase from inception up to 15 March 2024, yielding nine studies comprising 15,817 patients. Data were extracted from randomized and non-randomized studies reporting primary and secondary outcomes. The analysis was performed in Revman. Risk ratios were calculated with 95% confidence intervals, and a P -value of <0.05 was considered statistically significant. RESULTS A total of 13,081 patients underwent drain placement after left pancreatectomy, and 2,736 patients were included in the no-drain group. Out of the total, 45.1% (n=7140) patients were male, with 45.9% (n=6012) males in the drain group and 41.2% (n=1128) males in the no-drain group. Major morbidity, defined as Clavien-Dindo grade ≥III complications, was significantly lower in the no-drain group (relative risk [RR]: 0.77, 95% confidence interval [CI]: 0.64-0.93, P =0.006). Similarly, lower rates of postoperative pancreatic fistula (POPF) (RR: 0.51, 95% CI: 0.38-0.67, P <0.00001), readmission (RR: 0.75, 95% CI: 0.59-0.96, P =0.02), and surgical site infections (RR: 0.82, 95% CI: 0.70-0.95, P =0.009) were observed in the no-drain group. Additionally, a shorter length of hospital stay was noted in this group (mean difference MD: -1.65, 95% CI: -2.50 to -0.81, P =0.0001). CONCLUSIONS Omitting routine drainage after left pancreatectomy is associated with reduced complications and shorter hospital stays, supporting its potential benefits in improving postoperative outcomes.

中文翻译：

---

结果比较评估：左胰腺切除术后腹腔引流与无腹腔引流 - 系统评价和荟萃分析。


目的 本系统评价和荟萃分析旨在比较胰腺切除术后腹腔引流放置和不放置引流管的结局。背景 左胰腺切除术 （LP） 是一种常用于各种胰腺疾病的外科手术，通常与术后并发症有关，如术后胰瘘 （POPF）。虽然 LP 后常规腹腔引流一直是标准做法，但最近的证据表明省略这种方法可能有益。方法 对 PubMed、Cochrane 和 Embase 进行了从建库到 2024 年 3 月 15 日的全面检索，产生了 9 项研究，涉及 15,817 名患者。数据是从报告主要和次要结局的随机和非随机研究中提取的。分析在 Revman 中进行。用 95% 置信区间计算风险比，% 3C0.05 的 P 值被认为具有统计学意义。结果 13,081 例患者在左胰腺切除术后接受了引流置管，其中 2,736 例患者被纳入无引流组。在所有患者中，45.1% （n=7140） 患者为男性，引流组为 45.9% （n=6012） 男性，无引流组为 41.2% （n=1128） 男性。无引流组的主要并发症发生率，定义为 Clavien-Dindo ≥III 级并发症，显著降低 （相对风险 [RR]： 0.77,95% 置信区间 [CI]： 0.64-0.93，P =0.006）。同样，术后胰瘘 （POPF） 发生率较低 （RR： 0.51， 95% CI： 0.38-0.67， P <0.00001）、再入院率 （RR： 0.75， 95% CI： 0.59-0.96， P =0.02） 和手术部位感染 （RR： 0.82， 95% CI： 0.70-0.95， P =0.009） 在无引流组中观察到。此外，该组的住院时间较短 （平均差 MD： -1.65,95% CI：-2.50 至 -0.81，P =0.0001）。结论 左胰腺切除术后不常规引流与减少并发症和缩短住院时间有关，支持其在改善术后结局方面的潜在益处。