Trial reportAnnals of surgery2025
Reconsidering Abdominal Drainage After Left Pancreatectomy: The Randomized Controlled PANDRA II Trial.
Trial report in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.
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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.
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.
Who cites it
6 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Preventing pancreatic fistula following pancreatectomy: meta-analysis of randomized clinical trials.BJS open · 2026Pooled it
- Use and management of routine prophylactic abdominal drainage in pancreatic surgery: meta-analysis of randomized clinical trials.BJS open · 2025Pooled it
- Optimizing drain management following distal pancreatectomy: fewer drains and earlier removal guided by drain fluid amylase and C-reactive protein levels.Surgical endoscopy · 2026Article
- A Multicenter, Single-Blind, Randomized Trial Comparing Stapler Closure With Clip-on-Staple Method Versus Stapler Closure Alone During Distal Pancreatectomy (CLIP-DP Trial).Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Towards omission of drainage in distal pancreatectomy-the PANDRA II study: another brick in the wall!Hepatobiliary surgery and nutrition · 2026Article
- Quadruple reinforcement technique for pancreatic stump during robotic distal pancreatectomy.Surgical endoscopy · 2026Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate intra-abdominal drainage after left pancreatectomy (LP), as it has been a longstanding practice to mitigate postoperative complications, particularly postoperative pancreatic fistulas.
backgroundRecent studies challenge the necessity of routine drainage, suggesting potential benefits in omitting drains.
methodsThe PANDRA II trial was a randomized controlled noninferiority study conducted at the University Hospital Heidelberg between 2017 and 2023. It compared outcomes between patients undergoing open or minimally invasive LP with and without abdominal drainage. The primary endpoint was overall postoperative morbidity assessed by the Comprehensive Complication Index (CCI).
resultsA total of 246 patients were included in the intention-to-treat analysis (125 with drainage, 121 without drainage). The no-drain group demonstrated noninferiority to the drain group in terms of CCI (13.90 ± 16.51 vs 19.43 ± 16.92, P < 0.001 for noninferiority). Moreover, the no-drain group had lower overall complication rates (50.41% vs 78.40%, P < 0.001). Specific complications such as postoperative pancreatic fistula (14.88% vs 20.8%, P = 0.226) and postpancreatectomy hemorrhage (4.96% vs 4.80%, P > 0.999) did not differ significantly between groups.
conclusionsThe results of the PANDRA II trial demonstrate that omitting routine abdominal drainage after LP is noninferior to placing routine abdominal drainage regarding morbidity measured by the CCI. Omitting a routine abdominal drainage even led to a significant reduction in the overall complication rate.
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