Early Versus Routine Drain Removal After Live Liver Donor Hepatectomy

NCT ID: NCT04504487

Last Updated: 2022-05-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

108 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-28

Study Completion Date

2022-02-25

Brief Summary

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It's a randomized control trial to compare early drain removal versus standard drain removal after donor hepatectomy in terms of donor outcomes. We will analyse the data and elucidate the safety of early drain removal using 3x3 rule with routine drain removal.

Detailed Description

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* Prophylactic abdominal drainage after donor right hepatectomy for LDLT has been a common or even mandatory practice in most transplant centres.
* This serves to monitor the occurrence of postoperative intraabdominal bleeding and is used for the detection and drainage of any bile leakage.
* Below table mentions both advantages and disadvantages of prophylactic drain placement after hepatectomy.

Advantages

1. Early detection of haemorrhage
2. Early detection of bile leak
3. Early reintervention Disadvantages

1\. Increased rates of intraabdominal and wound infection, 2. Increased abdominal pain, 3. Decreased pulmonary function, 4. Prolonged hospital stay, 5. Bowel injury.

* Our study in ILBS for ALF donors, the overall complication rate was 20% as per Clavien-Dindo classification, of which a majority (15.9%) had grade 1 or 2 complications. Major complications (3b and above) were seen in 4 (1.0%) patients. Biliary complications were noted in 1.7% only.
* In a study by Japanese group concluded that 3 × 3 rule is clinically feasible and allows for the early removal of the drain tube with minimum infection risk after liver resection. The ''3 x 3 rule'': the drain will be removed when the drain fluid bilirubin concentration is \<3 mg/dl on day 3 after operation.
* In our institute we remove drain routinely, when output is less than 100ml and serous. That is usually on postoperative day 5-7.
* There is no randomized control trail done in donor hepatectomy comparing early versus standard drain removal.

Conditions

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Liver Transplant

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Early drain removal - POD3

Drain removal on POD3 if drain bilirubin is less than 3mg/dl and serous in nature.

Group Type EXPERIMENTAL

Drain Removal

Intervention Type OTHER

Abdominal drain placed during surgery removal

Routine Drain Removal

Drain removed routinely when the output is less than 100ml and serous in nature

Group Type PLACEBO_COMPARATOR

Drain Removal

Intervention Type OTHER

Abdominal drain placed during surgery removal

Interventions

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Drain Removal

Abdominal drain placed during surgery removal

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* • Donors evaluated as per institutional protocol for donor hepatectomy and found fit

* Those who consent

Exclusion Criteria

* Patients refusing to consent for inclusion in the study.
* Left lateral hepatectomy.
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Institute of Liver and Biliary Sciences, India

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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ILBS - Parthiban

Delhi, , India

Site Status

Countries

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India

References

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Durairaj P, Pamecha V, Mohapatra N, Patil NS, Sindwani G. Early drain removal after live liver donor hepatectomy is safe - a randomized controlled pilot study. Langenbecks Arch Surg. 2023 Sep 5;408(1):350. doi: 10.1007/s00423-023-03088-9.

Reference Type DERIVED
PMID: 37670194 (View on PubMed)

Related Links

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https://pubmed.ncbi.nlm.nih.gov/27138885/

Prospective Validation of Optimal Drain Management "The 3 × 3 Rule" after Liver Resection

https://pubmed.ncbi.nlm.nih.gov/30861306/

Living Donor Liver Transplantation for Acute Liver Failure: Donor Safety and Recipient Outcome

https://pubmed.ncbi.nlm.nih.gov/23027077/

Criteria for drain removal following liver resection

Other Identifiers

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ILBS/LIVEDONORS/01

Identifier Type: -

Identifier Source: org_study_id

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