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Peritoneal drainage (PD) of the operative bed following elective pancreatectomy has traditionally been utilized to hypothetically allow early recognition and potential therapeutic treatment of a pancreatic leak following reconstruction or ligation of the remnant gland. Recent literature suggests drainage is not helpful in those following pancreatectomy and in fact may be detrimental. Data specific to those having elective distal pancreatectomy (DP) has not received prior evaluation. We hypothesized that PD does not mitigate the morbidity or the need for post-operative therapeutic intervention in those having DP and further may not be an effective means toward preventing or recognizing intra-abdominal complications when they do occur. METHODS: We retrospectively reviewed 69 patients having elective DP at a university hospital from 1997-2010. Factors examined included the development of post-operative intra-abdominal complications (fistula, pseudocyst, bleeding, abscess) particularly those that required therapeutic intervention (radiologic drainage or re-operative surgery). PD was utilized at the discretion of the attending physician. Criteria for drain removal include output < 50cc/day and/or amylase value < 3X serum level. The comparison between those with and without drains was made utilizing chi-square analysis or Fischer’s exact test where appropriate with significance assessed at the 95th percentile. RESULTS: Sixty-nine patients had DP during the study period - 30 of who did not have PD. Sixty percent were female, 75% had surgery for malignancy and 23% had concurrent extra-pancreatic organ removal with no difference between groups. Thirty-four patients (49%) suffered 45 complications post-operatively. The majority of the morbidity was intra-abdominal in nature including 15 with abscess, 6 with pancreatic fistulae and 11 with pseudocysts. Twelve and 19 patients respectively required radiologic drainage, re-operation or both post-operatively. There was no difference between those with drains and those without with respect to overall or intra-abdominal complications, the need for radiologic drainage or re-operation. Of the 39 patients having PD, 19 had post-operative abdominal morbidity. The drain was useful in preventing, identifying, and/or treating the complication in only 3. CONCLUSIONS: 1) PD following elective DP does not confer a reduction in overall morbidity, post-operative intra-abdominal complications or the need for therapeutic intervention versus those with no drains. 2) The presence of a drain, in general, was not helpful in preventing, detecting or treating a post-operative intra-abdominal complication. 3) A multi-institutional, prospective, randomized study would be helpful to further investigate these preliminary findings.