The authors reviewed their recent experience with major hepatic resection in order to evaluate the role of abdominal drainage in the development and treatment of postoperative complications. Fifty-one patients underwent major hepatectomy with abdominal drainage; 44 of these patients (86%) for malignancy (average age at operation: 59 years). Drains were removed after a median period of 4 days. Major complications occurred in 16 patients (31%), and 3 patients (6%) had a fatal outcome. Twenty patients (39%) experienced minor complications, including 6 cases (12%) of ascitic leak from the insertion site. Considering the type and extent of liver resections reported in this series, these results suggest that abdominal drainage, if technically adequate and maintained for a short period, is not responsible for a high rate of postoperative complications. Its use, although questionable after limited resections, is, therefore, still recommended after difficult and extended hepatectomies.
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