ID: 174 (Conflict of Interest: K)

Ambulantes Drainagemanagement bei Patienten mit klinisch relevanter postoperativer Pankreasfistel - der aktuelle Stand in Deutschland

S.Hempel1, P.Püttmann1, C.Kahlert1, L.Seifert1, S. T.Mees1, T.Welsch2, J.Weitz2, M.Distler3
1Universitätsklinikum Dresden, Dresden
2Universitätsklinikum Carl Gustav Carus Dresden, Dresden
3Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden


Postoperative pancreatic fistula (POPF) is a common complication after pancreatic surgery associated with extended hospitalization, increased medical costs, and reduced quality of life. The aim of the present study was to assess the treatment of postoperative pancreatic fistulas in Germany with a special focus on the outpatient drain management in patients with clinically relevant POPF.

Material und Methoden

A questionnaire evaluating the postoperative management once a clinically postoperative pancreatic fistula is diagnosed -especially focusing on ambulatory drain management- was developed and sent to 211 German hospitals performing >12 pancreatic surgeries per year. Statistical analysis was carried out using SPSS 21.


The final response rate was 62% (131/211). An outpatient drainage management is performed by most of the responding hospitals (n=100, 76.3%).  However, 30% of hospitals perform an ambulatory treatment only in 5% of their cases with clinically relevant POPF. A correlation between caseload of the pancreatic centers and frequency of outpatient drain management was not seen. Mostly discharge criteria for patients with drained POPF (74.8%), the drain management itself (74.8%) and criteria for drain removal (56.5%) are not standardized but made individually. In centers with a standardized drain management criteria for drain removal contain drain amount <20 ml (29.8%), no fluid collection (25.2%), no elevation of drain amylase/lipase (25.2%) and no specific symptoms (22.1%).


This is the first national survey in Germany evaluating outpatient drain management in patients with clinically relevant POPF. Although the data in the literature are rare, the majority of German pancreas surgeons perform outpatient drain management. However, discharge criteria for patients with an inlaying drain, the outpatient care und the drain removal is standardized only in the minority of centers. Therefore, we recommend the evaluation of discharge criteria and a management algorithm for patients with drained POPF to improve the perioperative course.