TIMING OF DRAIN REMOVAL IN PATIENTS WITH CIRRHOSIS AND ASCITES FOLLOWING EMERGENCY GENERAL SURGERY Lee.Frank@mayo.edu

PE003

TIMING OF DRAIN REMOVAL IN PATIENTS WITH CIRRHOSIS AND ASCITES FOLLOWING EMERGENCY GENERAL SURGERY

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United States

Oral or Poster

Following emergent abdominal surgery, the postoperative management of ascites in patients with cirrhosis is challenging particularly the management of surgical drains. This study evaluated the association of duration of drain placement and patient outcomes.

A retrospective review was performed of adults with cirrhosis and ascites who underwent non-elective/non-transplant surgery with intraabdominal drain placement at a single institution from 2000-2024. Demographics, MELD score, operative details, and 30-day outcomes for intraabdominal infection, wound dehiscence, crystalloid/albumin replacement, paracentesis following drain removal, hospital length of stay (LOS), and mortality were collected. Data are presented as median [IQR]. Analysis was performed using Wilcoxon rank sum test and linear regression with significance <0.05.

Forty-two patients were included in the study. Median age at surgery was 66 [58-73]; 69% were male. Most common surgeries were exploratory laparotomy, open umbilical hernia repair, and open ventral hernia repair. Median MELD was 18 [13-21]. Half of patients were on diuretics. Drains were removed at median postoperative day 11 [7-15]. Intra-abdominal infection, wound dehiscence, and mortality rates were 31%, 26%, and 26%, respectively. There were no statistically significant associations between duration of drain placement and volume replacement, LOS, infection, wound dehiscence, paracentesis, or death.

Duration of drain placement was not associated with postoperative outcomes. Due to small sample size, subgroup analyses for procedure type could not be performed. Analysis with matched controls who had no drain placement is warranted. Development of an evidence-based standardized pathway for drain management in this complex patient population is needed.