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Review Article

Active Intra-Abdominal Drainage Following Abdominal Digestive System Surgery: A Meta-Analysis and Systematic Review

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Article: 2180115 | Received 13 Nov 2022, Accepted 08 Feb 2023, Published online: 21 Sep 2023
 

Abstract

Background

Our objective is to compare the early outcomes associated with passive (gravity) drainage (PG) and active drainage (AD) after surgery.

Methods

Studies published until April 28, 2022 were retrieved from the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Web of Science databases.

Results

Nine studies with 14,169 patients were identified. Two groups had the same intra-abdominal infection rate (RR: 0.55; P = 0.13); In subgroup analysis of pancreaticoduodenectomy, active drainage had no significant effect on postoperative pancreatic fistula (POPF) rate (RR: 1.21; P = 0.26) and clinically relevant POPF (CR-POPF) (RR: 1.05; P = 0.72); Active drainage was not associated with lower percutaneous drainage rate (RR: 1.00; P = 0.96), incidence of sepsis (RR: 1.00; P = 0.99) and overall morbidity (RR: 1.02; P = 0.73). Both groups had the same POPF rate (RR: 1.20; P = 0.18) and CR-POPF rate (RR: 1.20; P = 0.18) after distal pancreatectomy. There was no difference between two groups on the day of drain removal after pancreaticoduodenectomy (Mean difference: −0.16; P = 0.81) and liver surgery (Mean difference: 0.03; P = 0.99).

Conclusions

Active drainage is not superior to passive drainage and both drainage methods can be considered.

Authors’ contributions

Minghui zheng, Ting Niu, Junfeng Peng and Ligang Shi contributed equally to this work and share first authorship. Chenghao Shao: conceptualization, methodology, writing-reviewing and editing. Minghui zheng, Ting Niu, Junfeng Peng and Ligang Shi: data curation, writing-original draft preparation. All authors contributed to manuscript revision, read, and approved the submitted version.

Disclosure statement

The authors declare that they have no competing interests.