Evidence map›Paper›PMID 25183409›Full record

Trial reportJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2015

The value of drains as a fistula mitigation strategy for pancreatoduodenectomy: something for everyone? Results of a randomized prospective multi-institutional study.

Matthew T McMillan, William E Fisher, George Van Buren, Amy McElhany, Mark Bloomston, Steven J Hughes, Jordan Winter, Stephen W Behrman, Nicholas J Zyromski, Vic Velanovich and 3 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 14 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 14 pooled it
5.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 14 syntheses or guidelines pooled it, 90 citations in OpenAlex.

  1. Pooled it
  2. Prophylactic abdominal drainage for pancreatic surgery.The Cochrane database of systematic reviews · 2025
    Pooled it
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  4. Prophylactic abdominal drainage for pancreatic surgery.The Cochrane database of systematic reviews · 2021
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  9. Prophylactic abdominal drainage for pancreatic surgery.The Cochrane database of systematic reviews · 2018
    Pooled it
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  11. Prophylactic abdominal drainage for pancreatic surgery.The Cochrane database of systematic reviews · 2016
    Pooled it
  12. Pooled it
  13. Calculating the risk of a pancreatic fistula after a pancreaticoduodenectomy: a systematic review.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2015
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 10 institutions in 1 country.

Matthew T McMillanDepartment of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
William E Fisher
George Van Buren
Amy McElhany
Mark Bloomston
Steven J Hughes
Jordan Winter
Stephen W Behrman
Nicholas J Zyromski
Vic Velanovich
Kimberly Brown
Katherine A Morgan
Charles Vollmer
Baylor College of Medicine · USUniversity of Pennsylvania · USIndiana University – Purdue University Indianapolis · USMedical University of South Carolina · USThe Ohio State University · USThe University of Texas Medical Branch at Galveston · USThomas Jefferson University · USUniversity of Florida · USUniversity of South Florida · USUniversity of Tennessee Health Science Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA recent randomized, controlled trial investigating intraperitoneal drain use during pancreatoduodenectomy (PD) had a primary goal of assessing overall morbidity. It was terminated early with findings that routine elimination of drains in PD increases mortality and the severity and frequency of overall complications. Here, we provide a follow-up analysis of drain value in reference to clinically relevant postoperative pancreatic fistula (CR-POPF).

methodsNine institutions performed 137 PDs, with patients randomized to intraperitoneal drainage (N = 68) or no drainage (N = 69). The Fistula Risk Score (FRS), a 10-point scale derived from four validated risk factors for CR-POPF, facilitated risk adjustment between treatment groups.

resultsThere was no difference in fistula risk between the two cohorts. Overall, CR-POPF rates were higher in the no drain group compared to the drain group (20.3 vs. 13.2%; p = 0.269). Patients with negligible/low FRS risk had higher rates of CR-POPF when drains were used (14.8 vs. 4.0%; p = 0.352). Conversely, there were significantly fewer CR-POPFs (12.2 vs. 29.5%; p = 0.050) when drains were used with moderate/high risk patients. Lastly, moderate/high risk patients who suffered a CR-POPF had reduced 90-day mortality (22.2 vs. 42.9%) when a drain was used.

conclusionThe results of this analysis suggest that drains diminish the rate and severity of CR-POPF in patients with moderate/high risk, but they could possibly be avoided in the roughly one third of patients with negligible/low risk.

Indexed as

AdultAgedDrainageFemaleHumansMaleMiddle AgedPancreatic FistulaPancreaticoduodenectomyPostoperative ComplicationsProspective StudiesRisk Factors

Identifiers

PMID25183409
OpenAlexW2069229761

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.