Overall Incidence of Postoperative Pancreatic Fistula After Early Drain Removal in Distal Pancreatectomy

Background/Aim: Detailed evaluation of the overall incidence of postoperative pancreatic fistula (POPF) after early drain removal (EDR) in distal pancreatectomy (DP) is lacking. This study aimed to assess postoperative complications, including the overall incidence of POPF, with EDR following DP.

Patients and Methods: Ninety-nine patients who underwent EDR after DP regardless of drain fluid amylase level between January 2017 and December 2024 were enrolled in this study. Data were retrospectively analyzed to evaluate complications, including the overall incidence of POPF.

Results: The overall incidence of POPF after EDR was 31.3% (31/99 patients), of which the incidence of clinically relevant POPF requiring reinsertion of abdominal drains was 4.0% (4/99 patients). The incidence of Clavien–Dindo grade ≤ II POPF was high, at 27.3% (27/99 patients). There were no complications of Clavien–Dindo grade IV or V. Univariate analysis of pre- and intraoperative variables showed that injury to the pancreatic parenchyma near the pancreatic stump was the only risk factor for drain reinsertion after EDR.

Conclusion: EDR, regardless of drain fluid amylase level, reduces the incidence of Clavien–Dindo grade ≥ IIIa POPF after DP. However, EDR does not necessarily contribute to a decrease in the overall incidence of POPF after DP.