Initial suction drainage decreases severe postoperative complications after pancreatic trauma: A cohort study

Table 1 Baseline characteristics of patients before and after matching

Characteristics	Before matching				After matching
	PG (n = 146)	NPI (n = 50)	P value		PG (n = 44)	NPI (n = 44)		P value
Male sex, n (%)	137 (93.8)	43 (86.0)	0.148	41 (93.2)			39 (88.6)	0.518
Age, median (IQR)	40 (30.75-48.25)	44.5 (26.25-52.25)	0.058	39 (30.25-47.00)			44.5 (27-51)	0.843
BMI, mean ± SD	23.04 (3.68)	23.46 (3.62)	0.477	23.59 (4.48)			23.36 (3.57)	0.787
Blunt injury, n (%)	137 (93.8)	48 (96.0)	0.733	42 (95.5)			42 (95.5)	1.000
ISS, median (IQR)	17 (9-21)	16 (9-20)	0.183	16 (9-20)			16 (9-20)	0.936
Abdominal AIS, median (IQR)	3 (3-4)	3 (3-4)	0.146	3 (3-4)			3 (3-4)	0.985
Pancreatic injury grade, n (%)			0.090					0.829
Ⅰ + Ⅱ	45 (30.8)	22 (44.0)		19 (43.2)			18 (40.9)
Ⅲ + Ⅳ + Ⅴ	101 (69.2)	28 (56.0)		25 (56.8)			26 (59.1)
Isolated pancreatic injury, n (%)			0.489					1.000
No	123 (84.2)	40 (80.0)		35 (79.5)			35 (79.5)
Yes	23 (15.8)	10 (20.0)		9 (20.5)			9 (20.5)
Duodenum injury, n (%)			0.043					1.000
No	116 (79.5)	46 (92.0)		39 (88.6)			40 (90.9)
Yes	30 (20.5)	4 (8.0)		5 (11.4)			4 (9.1)
Vascular injury, n (%)			0.032					0.787
No	127 (87.0)	37 (74.0)		35 (79.5)			36 (81.8)
Yes	19 (13.0)	13 (26.0)		9 (20.5)			8 (18.2)
Parenchyma organ injury, n (%)			0.242					0.831
No	62 (42.5)	26 (52.0)		22 (50.0)			23 (52.3)
Yes	84 (57.5)	24 (48.0)		22 (50.0)			21 (47.7)
Hollow organ injury, n (%)			0.144					1.000
No	53 (36.3)	24 (48.0)		20 (45.5)			20 (45.5)
Yes	93 (63.7)	26 (52.0)		24 (54.5)			24 (54.5)
Shock on admission, n (%)			0.597					0.777
No	127 (87.0)	42 (84.0)		36 (81.8)			37 (84.1)
Yes	19 (13.0)	8 (16.0)		8 (18.2)			7 (15.9)
Number of abdominal organ injuries, n (%)			0.093					0.631
2	49 (33.6)	22 (44.0)		18 (40.9)			20 (45.4)
≥ 3	74 (50.7)	18 (36.0)		17 (38.6)			15 (34.1)
Time to operation, n (%)			0.001					1.000
< 24 h	116 (79.5)	27 (54.0)		27 (61.4)			27 (61.4)
≥ 24 h	30 (20.5)	23 (46.0)		17 (38.6)			17 (38.6)

PG: Passive gravity; NPI: Negative pressure irrigation; IQR: Inter-quartile range; BMI: Body mass index; SD: Standard deviation; ISS: Injury severity score; AIS: Abbreviated injury scale.

Table 2 Operative procedures between two drain types before and after matching cohorts

Operative procedure	Before matching			After matching
	PG (n = 146)	NPI (n = 50)	P value	PG (n = 44)	NPI (n = 44)	P value
Pancreas injury-related, n (%)
Peripancreatic drainage alone	61 (41.8)	22 (44.0)	0.784	19 (43.2)	19 (43.2)	1.000
Distal pancreatectomy	37 (25.3)	10 (20.0)	0.445	10 (22.7)	8 (18.2)	0.597
Distal pancreatectomy + splenectomy	22 (15.1)	9 (18.0)	0.624	6 (13.6)	8 (18.2)	0.560
Pancreaticojejunostomy	21 (14.4)	7 (14.0)	0.947	8 (18.2)	7 (15.9)	0.777
Whipple	5 (3.4)	2 (4.0)	0.850	1 (2.3)	2 (4.5)	1.000
Other intra-abdominal organ injury-related, n (%)
Gastric or duodenal	38 (26.0)	6 (12.0)	0.040	5 (11.4)	5 (11.4)	1.000
Jejunal or ileal	25 (17.1)	9 (18.0)	0.888	9 (20.5)	9 (20.5)	1.000
Colorectal	30 (20.5)	11 (22.0)	0.828	10 (22.7)	10 (22.7)	1.000
Parenchymal organ	58 (39.7)	12 (24.0)	0.045	11 (25.0)	10 (22.7)	0.803
Vascular	19 (13.0)	13 (26.0)	0.032	9 (20.5)	8 (18.2)	0.787

PG: Passive gravity; NPI: Negative pressure irrigation.

Table 3 Postoperative outcomes of passive gravity vs negative pressure irrigation group before and after matching cohorts

Outcomes	Before matching			After matching
	PG (n = 146)	NPI (n = 50)	P value	PG (n = 44)	NPI (n = 44)	P value
Clavien-Dindo grade ≥ Ⅲb, n (%)	66 (45.2)	14 (28.0)	0.033	21 (47.7)	11 (25.0)	0.045
Pancreas-related, n (%)	70 (47.9)	15 (30.0)	0.027	23 (52.3)	13 (29.5)	0.050
Pancreatic fistula grade B/C	62 (42.5)	13 (26.0)	0.039	22 (50.0)	11 (25.0)	0.027
Pancreatic pseudocyst	2 (1.4)	2 (4.0)	0.269	0	2 (4.5)	0.494
Peripancreatic abscess	6 (4.1)	0	0.341	1 (2.3)	0	1.000
Organ failure, n (%)	37 (25.3)	9 (18.0)	0.290	6 (13.6)	3 (6.8)	0.484
Circulatory failure	23 (15.8)	6 (12.0)	0.519	4 (9.1)	2 (4.5)	0.676
Respiratory failure	20 (13.7)	5 (10.0)	0.499	4 (9.1)	1 (2.3)	0.360
Renal failure	24 (16.4)	7 (14.0)	0.683	5 (11.4)	3 (6.8)	0.713
Gastrointestinal fistulas, n (%)	50 (34.2)	10 (20.0)	0.059	17 (38.6)	7 (15.9)	0.030
Hemorrhage grade B/C, n (%)	34 (23.3)	7 (14.0)	0.163	12 (27.3)	6 (13.6)	0.080
Intra-abdominal abscess, n (%)	20 (13.7)	8 (16.0)	0.688	7 (15.9)	5 (11.4)	0.534
Sepsis, n (%)	27 (18.5)	7 (14.0)	0.469	4 (9.1)	3 (6.8)	1.000
In-hospital mortality, n (%)	16 (11.0)	3 (6.0)	0.412	3 (6.8)	2 (4.5)	1.000
Reoperation, n (%)	55 (38.2)	11 (22.0)	0.037	16 (36.4)	7 (15.9)	0.029
CT-drainage, n (%)	47 (32.2)	9 (18.0)	0.038	15 (34.1)	7 (15.9)	0.042
Drainage period, median (IQR)	47.0 (30.0-75.25)	37.0 (20.0-54.25)	0.002	47.0 (30.0-68.0)	35.0 (20.0-54.75)	0.009
LOS, median (IQR)	65.5 (47.75-97.0)	43.5 (30.5-69.25)	0.002	62.5 (43.75-97.0)	44.0 (33.0-69.75)	0.047

Clavien–Dindo complications in this category include those that resulted in surgical, endoscopic, or radiologic intervention (Clavien–Dindo grade III), those without general anesthesia (III_a), those that required general anesthesia (III_b), those that required care in the intensive care unit (Clavien–Dindo grade IV), and those that resulted in death (Clavien–Dindo grade V). PG: Passive gravity; NPI: Negative pressure irrigation; CT: Computed tomography; IQR: Inter-quartile range; LOS: Length of stay.