Is Intraperitoneal Drainage Necessary Following Distal Pancreatectomy: A Randomized Control Trial
Summary
The goal of this clinical trial is to analyze if intraperitoneal drainage is necessary following distal pancreatectomy. This study aims to determine whether the omission of routine intraperitoneal drainage in the setting of reinforced staple technology is non-inferior to routine intraperitoneal drainage with respect to a composite post-operative complications of Grade B or C Postoperative pancreatic fistula (POPF), readmission, or organ space surgical site infection following a distal pancreatectomy.
Detailed description
Pancreatic resections are commonly performed across the United States, yet still represent one of the most morbid abdominal operations in the country, with postoperative mortality as high as 7.7%. Distal pancreatectomy (DP) represents one of the most common approaches to pancreatic resection and is typically used for tumors of the pancreatic body or tail. This operation is known to have a high historic morbidity, with reports of overall morbidity between 12-52%. Common complications include intraabdominal abscess and surgical site infection. Postoperative pancreatic fistula (POPF) represents the most common complication following partial pancreatic resection, with rates reported with rates as high as 30% in multiple large retrospective studies. Multiple strategies to prevent postoperative pancreatic leak following distal pancreatectomy have been studied. One of the outstanding questions that remains is regarding the need for routine intraperitoneal drainage following DP, particularly since the advent of reinforced staple technology. This study aims to determine if intraperitoneal drainage is necessary following DP. This study will compare groups using a composite endpoint of complications.
Arms & interventions
- Device19 French Blake Drain
19 French Blake Intraperitoneal Drain will be placed near the pancreatic resection margin
Outcome measures
Primary
Composite endpoint comparison
Comparison between groups using a composite endpoint of complications that includes presence of Grade B POPF
Time frame: Within 90 days of surgery
Composite endpoint comparison
Comparison between groups using a composite endpoint of complications that includes presence of Grade C POPF
Time frame: Within 90 days of surgery
Composite endpoint comparison
Comparison between groups using a composite endpoint of complications that includes Readmission
Time frame: Within 90 days of surgery
Composite endpoint comparison
Comparison between groups using a composite endpoint of complications that includes presence of Organ Space Surgical Site Infection
Time frame: Within 90 days of surgery
Secondary
Rates of endoscopic drainage vs percutaneous drainage of Grade B POPF
Time frame: 90-day post operative time point
Quality of Life Score
Time frame: At day 14 postoperative
Quality of Life Score
Time frame: At day 14 postoperative
Quality of Life Score
Time frame: At day 14 postoperative
Quality of Life Score
Time frame: At day 90 postoperative
Quality of Life Score
Time frame: At day 90 postoperative
Quality of Life Score
Time frame: At day 90 postoperative
Hospital Length of Stay
Time frame: 90-day post operative time point
Cost analysis for overall healthcare costs
Time frame: At day 90 postoperative
Eligibility criteria
Study locations (1)
Cleveland Clinic Taussig Cancer Institute, Case Comprehensive Cancer Center
Cleveland, Ohio, 44195