Please select the eligibility criteria that correspond to the clinical trial below.
Title: Early (4 Days) Versus Standard Drainage Removal of the Abdominal Cavity After Pancreaticoduodenectomy- - A Randomized Multicenter Study
Brief Summary: Around two thousand pancreaticoduodenectomy (PD) are performed each year in France. This intervention is associated with a high rate of postoperative complications including:

* pancreatic fistulas (PF);
* surgical site infections (intra-abdominal abscess, wound infection);
* delayed gastric emptying (gastroparesis);
* and hemorrhage.

The incidence of SSI (superficial and deep) is about 35% and seems influenced by the prolonged intra-abdominal drainage. For several years, there has been a global trend to reduce the use of abdominal drainage after abdominal surgery. Several randomized clinical trials have shown that prophylactic drainage does not decrease the incidence of postoperative complications during elective hepatectomy, colectomy, and cholecystectomy and could increase the number of SSI. However, the role of prophylactic drainage after PD is so far unclear.

The aim of this prospective randomized multicenter study is to evaluate the influence of early (4 days) versus standard (10 to 15 days, depending on the staff clinical practice) drainage removal of the abdominal cavity after PD, on the rate of SSI.

Materials and Methods: The technique of PD is left at the discretion of the operator as well as the prescription of analogues of somatostatin. Drainage of the abdominal cavity is made of one or two round silicone close suction drains or open multichannel silicone drains placed in the vicinity of the pancreatic and biliary anastomosis. Shall be excluded patients operated on for chronic pancreatitis and patients who underwent preoperative radiotherapy. The 3rd postoperative day, a fistula is sought clinically, biologically and on CT-scanner images. In case of pancreatic fistula, the patient is excluded from randomization and drainage of the abdominal cavity is left in place depending on the different teams' practice. Patients without fistula are randomized to either drainage removal 4 days after surgery (D4) or standard drainage.


Options:
A: Inclusion Criteria:

* The subject has a surgical indication for distal pancreatectomy.
* In the opinion of the surgeon, the subject has no medical contraindications to pancreatectomy.
* At least 18 years of age.
* The subject is willing to consent to randomization to the intraperitoneal drain vs. no drain group.
* The subject is willing to comply with 90-day follow-up and answer quality-of-life questionnaires per protocol.

Exclusion Criteria:

* The subject does not have a surgical indication for distal pancreatectomy.
* In the opinion of the surgeon, the subject has medical contraindications to pancreatectomy.
* Less than 18 years of age.
* The subject is not willing to consent to randomization to the intraperitoneal drain vs. no drain group.
* The subject is not willing to comply with 90-day follow-up and answer quality-of-life questionnaires per protocol.
B: Inclusion Criteria:

* Pancreatic tumor regardless of its nature: All patients requiring PD (following thesaurus or multidisciplinary team council recommendation) for this indication will be included.
* Ability to participate in a clinical research protocol.
* Given informed consent.

Exclusion Criteria:

* History of pancreatic surgery or biliary diversion and / or digestive
* Patient taken in charge for chronic pancreatitis without tumor
* History of supramesocolic radiotherapy
* Sick supported emergency
* Physical or mental condition does not allow participation in the study
* Contra-indication to surgery
* ASA classification (American Society of Anesthesiologists) IV-V or life expectancy \<48
* Pregnancy or breastfeeding
* Patient under guardianship or private patient of liberty by a judicial or administrative decision
* Age under 18yo
C: Inclusion Criteria:

* Written Informed consent obtained；
* Both sexes between 18 and 80 years old；
* Patients scheduled to elective open pancreaticoduodenectomy.

Exclusion Criteria:

* Patients with ASA score \>=4;
* Patients who had a previous pancreatic operation;
* Patients with an immunodeficiency;
* Patients who underwent an emergency operation;
* Pregnant patients；
* Patients who was found that pancreaticoduodenectomy was not suitable。
D: Inclusion Criteria:

* Patients undergone either pancreaticoduodenectomy (reconstruction by pancreaticojejunostomy) or distal pancreatectomy with an amylase value in drains on postoperative day 1 less than 5000 IU/L

Exclusion Criteria:

* Pancreaticoduodenectomy reconstructed with pancreaticogastrostomy
* Clinical suspect of postoperative haemorrhage within 72hours after the operation
* Clinical suspect of biliary fistula
* Fluid collection greater than 3cm at an ultrasound carried out on postoperative day 3

Answer: B