Table 1 Details and characteristics of studies.
Author year | Country | Study type | Number of patients with liver resection | Number of patients with major liver resection | Inclusion criteria | Exclusion criteria | Type of drain | Indications for surgery | Cirrhotic patients | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
Total | Drain used | No drain used | |||||||||
Belgithi 1993 | France | RCT | 81 | 24 | 14 | 10 | NCD | Patients with: 1-Bilioenteric anastomosis (n = 6), 2-Gastrointestinal procedure (n = 6), 3-Extended hepatic resection with total vascular exclusion and/or ex situ perfused liver (n = 5), 4-Devitalized hepatic stump tissues (n = 2), 5-Injury to the common bile duct (n = 2), 6-Refusal to participate (n = 3) | Closed suction drain | 42 (51.8%) with benign lesions and 39 (48.2%) with malignant tumors such as HCC (21 patients), CCC (4 patients) and metastasis (14 patients) | 19 (23.4%) |
Fong 1996 | USA | RCT | 120 | 87 | 44 | 43 | NCD | Patients with: 1-Refusal to participate, 2-Thoracoabdominal biliary-enteric simultaneous anastomosis, 3-Preoperative placement of a biliary stent | Closed suction drain | 84 (70%) had metastatic cancer and 36 (30%) had primary liver pathology | 6 (5%) [2 in no-drain group and 4 in drain group] |
Kim 2014 | Korea | RCT | 200 | 130 | 64 | 66 | NCD | Patients with: 1-Surgeons preference (n = 1) 2-Intraoperative injury of hepatic duct (n = 1) | Closed suction drain | 50 (25%) with benign lesions [21 in no-drain group and 29 in drain group] and 150 (75%) with malignant tumors [79 in no-drain group and 71in drain group] | 108 (54%) [55 in no-drain group and 53 in drain group] |
Aldameh 2005 | New Zealand | NRS | 211 | 111 | 79 | 32 | Patients with resection of hepatic parenchyma only | Patients with: 1-Bilioenteric anastomosis | 18F closed non-suction drain | 31 (14.6%) with benign lesions [19 in no-drain group and 12 in drain group] and 146 (69.2%) with malignant tumors [54 in no-drain group and 92 in drain group] HCC [20 (9.5%)] Metastasis [109 (51.6%)] CCC [8 (3.8%)] Gallbladder cancer [9 (4.2%)] | NCD |
Squires 2015 | USA | NRS | 1041 | 1041 | 564 | 477 | NCD | Patients with: 1-Concurrent biliary reconstruction and anastomosis (n = 198) | Closed drain | 215 (20.6%) with benign lesions [96 in no-drain group and 119 in drain group] and 822 (78.9%) with malignant tumors [381 in no-drain group and 441 in drain group] HCC [123 (11.8%)] Metastasis [626 (60.1%)] CCC [73 (7%)] | 20 (2%) [7 in no-drain group and 13 in drain group] |
Cauchy 2016 | France | NRS | 223 | 223 | 63 | 160 | 1-Patients undergoing full laparoscopic major right or left liver resection, 2-Lesions well clear of the midplane | Patients with: 1-Planned ‘‘hand-assisted’’ or ‘‘hybrid’’ approach, 2-Total vascular exclusion without or with liver cooling, 3-Reconstruction of major vascular were required | NCD | 26 (11.7%) with benign lesions and 197 (88.3%) with malignant tumors HCC [44 (19.7%)] Metastasis [112 (50.2%)] CCC [27 (12.1%)] Others [14 (6.3%)] | NCD |
Shwaartz 2017 | USA | NRS | 1005 | 1005 | 500 | 505 | Patients with major liver resection | Patients with: 1. Minor hepatectomy (n = 1,246), 2. Biliary reconstruction, 3. Missing info (n = 17) | NCD | 159 (15.8%) with benign lesions [71 in no-drain group and 88 in drain group] and 785 (78.1%) with malignant tumors [377 in no-drain group and 408 in drain group] Hepatobiliary cancers [271 (27%)] Metastasis [514 (51.1%)] | 83 (8.2%) [28 in no-drain group and 55 in drain group] |
Martin 2018 | USA | NRS | 6861 | 2429 | 1342 | 1087 | Adult patients ≥ 18 years old | Patients with: 1.Missing bile leak variable (n = 59), 2.Unknown or missing final pathologic diagnosis (n = 7), 3.An ICD-9 code indicating neoplasm of uncertain behavior | NCD | 5226 (76.2%) malignant tumors | NCD |
Total | 9742 | 5050 | 2670 | 2380 | |||||||
