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The following is a summary of “Reconsidering Abdominal Drainage After Left Pancreatectomy – The Randomized Controlled PANDRA II Trial,” published in the February 2025 issue of Annals of Surgery by Kaiser et al. 

Researchers conducted a retrospective study to evaluate the efficacy of intraabdominal drainage following left pancreatectomy (LP) in preventing postoperative complications, particularly postoperative pancreatic fistulas (POPF). 

They carried out the PANDRA II trial as a randomized controlled non-inferiority study at the University Hospital Heidelberg from 2017 to 2023. The study compared findings in patients who underwent open or minimally invasive LP with or without intraabdominal drainage. The primary endpoint was overall postoperative morbidity, measured using the Comprehensive Complication Index (CCI).  

The results showed that 246 patients were examined using the intention-to-treat approach (125 with drainage, 121 without drainage). The no-drain group proved non-inferior to the drain group in terms of the CCI (13.90 ± 16.51 vs 19.43 ± 16.92, P <0.001 for non-inferiority). Overall complication rates were lower in the no-drain group (50.41% vs 78.40%, P <0.001). The incidence of POPF (14.88% vs 20.8%, P =0.226) and postpancreatectomy hemorrhage (PPH) (4.96% vs 4.80%, P >0.999) showed no significant difference between groups.  

Investigators concluded that omitting routine abdominal drainage after laparoscopic pancreatic surgery was non-inferior to routine drainage and resulted in fewer complications. 

Source: journals.lww.com/annalsofsurgery/abstract/9900/reconsidering_abdominal_drainage_after_left.1188.aspx