Abstract
The 2013 Clinical Practice Guidelines for Hepatocellular Carcinoma mention that drain placement is not always necessary after elective liver resection. However, No-drain policy has not been widely used. In principle, a prophylactic drain is not placed after hepatectomy, in our institution. This study was designed to assess the feasibility of non-drain policy after hepatectomy by investigating postoperative complications in patients without abdominal drainage. The study included 270 patients who had undergone liver resection without placement of drains in our institution between January 2009 and December 2015. Among the 270 cases, 24 cases (8.9%) exhibited postoperative complications ≥ grade II by the Clavien-Dindo classification. The complications included pleural effusion and/or ascites (n = 6), intra-abdominal abscess (n = 3), ileus (n = 3), cardiopulmonary event (n = 3), wound infection (n = 3), bile leakage (n = 2), liver failure (n = 1), and others (n = 3). Among these, 7 cases (2.6%) required postoperative abdominal drainage. The above mentioned incidence of postoperative complications in our series without drain after liver resection was better than that reported in previous studies, suggesting the feasibility of omitting a prophylactic drain after hepatectomy.
