The Comparison between Prophylactic Drainage and Non-Prophylactic Drainage in Peptic Ulcer Perforation at Sawangdand in Crown Prince Hospital.
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Abstract
Background: Peptic ulcer perforation is the most common cause of acute peritonitis, necessitating urgent surgical treatment. Following surgery, surgeons frequently insert a protective abdominal catheter to monitor for any leakage from the sutured stomachand duodenum. However, prophylactic drainage after surgery is currently a topic of debate, as there is no clear empirical evidence of its benefits. Some international institutions do not recommend prophylactic drainage for all patients.
Objective: To compare the clinical outcome of prophylactic drainage and non-prophylactic drainage in peptic ulcer perforation at Sawangdandin Crown Prince Hospital.
Methods: We conducted a retrospective study of patients diagnose with Peptic ulcer perforation. Between January 2019 and February 2023. A total of 70 patients were included in this study, patients were divided into two groups, there were 46 patients in the drain group and 24 patients in the no drain group. The study compare hospital stay, operative time, pain scores and complications after surgery.
Results: General patient information such as mean age, body index (BMI), and ASA score between the drain and no drain groups were not significantly different (Age 59.7±12.2 vs. 53.8±13.4; p=0.069, BMI 20.7±2.0 vs. 21.3±3.5; p=0.493, ASA score 11.4% vs. 88.6%; p=0.320). There were found that the length of time spends in hospital (hospital stay) and pain scores after the first 24 hours of surgery were significantly different higher in the drain group than in the no drain groups (Hospital stay 7.1±1.6 vs.5.7±0.7; p=<0.001, Post-operative pain 4.8±2.1 vs.3.1±1.9;p=<0.001). As for the operative time, wound size and post-operative complications there were no significant differences between the two groups (Operative duration 43.1±9.6 vs.40.6±8.7; p=0.300, Perforation size 0.5±0.1 vs. 0.4± 0.1; p=0.064, Complication 17.4% vs. 8.3%; p=0.304).
Conclusion: Patients who did not have prophylactic drainage after peptic ulcer perforated surgery had shorter hospital stays and lower pain score than patient who had drains group.
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