Postoperative computed tomography findings predict re-drainage cases after early drain removal in pancreaticoduodenectomy

Purpose This study aimed to investigate the risk factors for re-drainage in patients with early drain removal after pancreaticoduodenectomy (PD). Methods This study retrospectively analyzed 114 patients who underwent PD and prophylactic drain removal on postoperative day (POD) 4 between January 2012 and March 2021. We analyzed the risk factors for re-drainage according to various factors. Peri-pancreaticojejunostomic fluid collection (PFC) index and pancreatic cross-sectional area (CSA) were evaluated using computed tomography on POD 4. The PFC index was calculated by multiplying the length, width, and height at the maximum aspect. Results Among the 114 patients, 15 (13%) underwent re-drainage due to postoperative pancreatic fistula. Multivariate analysis identified a PFC index ≥ 8.16 cm 3 on POD 4 (odds ratio [OR], 20.40, 95%CI 2.38–174.00; p = 0.006) and pancreatic CSA on POD 4 ≥ 3.65 cm 2 (OR, 16.40, 95%CI 1.57–171.00; p = 0.020) as independent risk factors for re-drainage. Conclusion A careful decision might be necessary for early drain removal in patients with a PFC index ≥ 8.16 cm 3 and pancreatic CSA ≥ 3.65 cm 2 .