Postoperative pancreatic fistula (POPF) is a challenging complication in pancreatic resection. A recent study evaluated the hypothesis that Gravity drainage (GD) reduces POPF versus closed-suction drainage (CSD). 

The study analyzed Six-hundred-twenty-nine patients undergoing pancreatic resection between 2013 and 2020 with multivariable logistic regression to investigate POPF and clinically-relevant POPF (crPOPF).

It found that-

• 63.1% of patients underwent pancreaticoduodenectomy, and 36.9% underwent distal pancreatectomy.
• 93.5% of patients received suction drains, whereas 6.5% had GDs.
• 27.6% patients experienced a POPF; 10% crPOPFs.
• multivariable analysis showed non- association of suction drainage with an increased risk of POPF or crPOPF.

Thus, the study inferred that Suction drainage does not promote POPF compared to GDs. Drain type should be determined by surgeon preference considering nursing and patient-specific considerations, especially while discharging patients with drains.

Am J Surg. 2022 Aug;224(2):737-741. doi: 10.1016/j.amjsurg.2022.02.063.