Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections

Abstract Prophylactic drainage after major liver resection remains controversial. This systematic review and meta-analysis evaluate the value of prophylactic drainage after major liver resection. PubMed, Web of Science, and Cochrane Central were searched. Postoperative bile leak, bleeding, intervent...

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Autores principales:	Sepehr Abbasi Dezfouli, Umut Kaan Ünal, Omid Ghamarnejad, Elias Khajeh, Sadeq Ali-Hasan-Al-Saegh, Ali Ramouz, Roozbeh Salehpour, Mohammad Golriz, De-Hua Chang, Markus Mieth, Katrin Hoffmann, Pascal Probst, Arianeb Mehrabi
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/14fe9fdf91b345158a6c1b66a0496085
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spelling	oai:doaj.org-article:14fe9fdf91b345158a6c1b66a04960852021-12-02T10:44:08ZSystematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections10.1038/s41598-021-82333-x2045-2322https://doaj.org/article/14fe9fdf91b345158a6c1b66a04960852021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-82333-xhttps://doaj.org/toc/2045-2322Abstract Prophylactic drainage after major liver resection remains controversial. This systematic review and meta-analysis evaluate the value of prophylactic drainage after major liver resection. PubMed, Web of Science, and Cochrane Central were searched. Postoperative bile leak, bleeding, interventional drainage, wound infection, total complications, and length of hospital stay were the outcomes of interest. Dichotomous outcomes were presented as odds ratios (OR) and for continuous outcomes, weighted mean differences (MDs) were computed by the inverse variance method. Summary effect measures are presented together with their corresponding 95% confidence intervals (CI). The certainty of evidence was evaluated using the Grades of Research, Assessment, Development and Evaluation (GRADE) approach, which was mostly moderate for evaluated outcomes. Three randomized controlled trials and five non-randomized trials including 5,050 patients were included. Bile leakage rate was higher in the drain group (OR: 2.32; 95% CI 1.18–4.55; p = 0.01) and interventional drains were inserted more frequently in this group (OR: 1.53; 95% CI 1.11–2.10; p = 0.009). Total complications were higher (OR: 1.71; 95% CI 1.45–2.03; p < 0.001) and length of hospital stay was longer (MD: 1.01 days; 95% CI 0.47–1.56 days; p < 0.001) in the drain group. The use of prophylactic drainage showed no beneficial effects after major liver resection; however, the definitions and classifications used to report on postoperative complications and surgical complexity are heterogeneous among the published studies. Further well-designed RCTs with large sample sizes are required to conclusively determine the effects of drainage after major liver resection.Sepehr Abbasi DezfouliUmut Kaan ÜnalOmid GhamarnejadElias KhajehSadeq Ali-Hasan-Al-SaeghAli RamouzRoozbeh SalehpourMohammad GolrizDe-Hua ChangMarkus MiethKatrin HoffmannPascal ProbstArianeb MehrabiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sepehr Abbasi Dezfouli Umut Kaan Ünal Omid Ghamarnejad Elias Khajeh Sadeq Ali-Hasan-Al-Saegh Ali Ramouz Roozbeh Salehpour Mohammad Golriz De-Hua Chang Markus Mieth Katrin Hoffmann Pascal Probst Arianeb Mehrabi Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections
description	Abstract Prophylactic drainage after major liver resection remains controversial. This systematic review and meta-analysis evaluate the value of prophylactic drainage after major liver resection. PubMed, Web of Science, and Cochrane Central were searched. Postoperative bile leak, bleeding, interventional drainage, wound infection, total complications, and length of hospital stay were the outcomes of interest. Dichotomous outcomes were presented as odds ratios (OR) and for continuous outcomes, weighted mean differences (MDs) were computed by the inverse variance method. Summary effect measures are presented together with their corresponding 95% confidence intervals (CI). The certainty of evidence was evaluated using the Grades of Research, Assessment, Development and Evaluation (GRADE) approach, which was mostly moderate for evaluated outcomes. Three randomized controlled trials and five non-randomized trials including 5,050 patients were included. Bile leakage rate was higher in the drain group (OR: 2.32; 95% CI 1.18–4.55; p = 0.01) and interventional drains were inserted more frequently in this group (OR: 1.53; 95% CI 1.11–2.10; p = 0.009). Total complications were higher (OR: 1.71; 95% CI 1.45–2.03; p < 0.001) and length of hospital stay was longer (MD: 1.01 days; 95% CI 0.47–1.56 days; p < 0.001) in the drain group. The use of prophylactic drainage showed no beneficial effects after major liver resection; however, the definitions and classifications used to report on postoperative complications and surgical complexity are heterogeneous among the published studies. Further well-designed RCTs with large sample sizes are required to conclusively determine the effects of drainage after major liver resection.
format	article
author	Sepehr Abbasi Dezfouli Umut Kaan Ünal Omid Ghamarnejad Elias Khajeh Sadeq Ali-Hasan-Al-Saegh Ali Ramouz Roozbeh Salehpour Mohammad Golriz De-Hua Chang Markus Mieth Katrin Hoffmann Pascal Probst Arianeb Mehrabi
author_facet	Sepehr Abbasi Dezfouli Umut Kaan Ünal Omid Ghamarnejad Elias Khajeh Sadeq Ali-Hasan-Al-Saegh Ali Ramouz Roozbeh Salehpour Mohammad Golriz De-Hua Chang Markus Mieth Katrin Hoffmann Pascal Probst Arianeb Mehrabi
author_sort	Sepehr Abbasi Dezfouli
title	Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections
title_short	Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections
title_full	Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections
title_fullStr	Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections
title_full_unstemmed	Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections
title_sort	systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/14fe9fdf91b345158a6c1b66a0496085
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Systematic review and meta-analysis of the efficacy of prophylactic abdominal drainage in major liver resections

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