Hepatobiliary Pancreatic Surgery at the Forefront

Shah, Sudeep R.; Khandelwal, Chiranjiva; Sharma, Atul

doi:10.1007/s12262-011-0389-0

Cited by 2 publications

(15 citation statements)

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“…Ten studies provided information about overall complications. 10 , 13 – 21 Complications were present in 58 of 884 patients (6.6%) in the drain group and 30 of 888 patients (3.4%) in the no drain group. Pooled analysis showed a statistically significant OR in favor of the no drain group (OR, 1.97; 95% CI, 1.26 to 3.10; P = .003) ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 98%

“… 12 Twelve studies in all fulfilled the inclusion criteria and were suitable for the meta-analysis. 9 – 11 , 13 – 21 All trials compared the use of prophylactic drainage with no drainage in elective LC with the exception of the study of Lucarelli et al, 21 which included only emergency procedures for acute calculous cholecystitis. Figure 1 shows the PRISMA flowchart for study inclusion and exclusion.…”

Section: Resultsmentioning

confidence: 99%

“…Eleven trials had adequate generation of randomization. 9 , 11 , 14 – 21 Allocation concealment was adequate in 9 studies. 11 , 13 , 15 – 21 The trials of Picchio et al 20 and Lucarelli et al 21 had adequate blinding of patients, surgeons, and assessors.…”

Section: Resultsmentioning

confidence: 99%

“… 15 – 17 , 19 – 21 Intention-to-treat analysis was used in 10 trials. 9 , 11 , 13 , 15 – 21 In one trial 7 patients were excluded because of conversion to open cholecystectomy. 14 In the study of Georgiou et al, 17 14 patients were excluded because an inflamed gallbladder was present at the operation.…”

Section: Resultsmentioning

confidence: 99%

“…After the publication of the aforementioned review, 7 other randomized trials have been published. 15 – 21 The aim of our study was to perform a systematic review and meta-analysis including these new studies to assess the utility of drainage in reducing complications after both emergent and elective LC.…”

Section: Introductionmentioning

confidence: 99%

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Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy

Picchio¹,

Lucarelli

Filippo

et al. 2014

JSLS

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Background and Objectives:Routine drainage after laparoscopic cholecystectomy is still controversial. This meta-analysis was performed to assess the role of drains in reducing complications in laparoscopic cholecystectomy.Methods:An electronic search of Medline, Science Citation Index Expanded, Scopus, and the Cochrane Library database from January 1990 to June 2013 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in laparoscopic cholecystectomy. The odds ratio for qualitative variables and standardized mean difference for continuous variables were calculated.Results:Twelve randomized controlled trials were included in the meta-analysis, involving 1939 patients randomized to a drain (960) versus no drain (979). The morbidity rate was lower in the no drain group (odds ratio, 1.97; 95% confidence interval, 1.26 to 3.10; P = .003). The wound infection rate was lower in the no drain group (odds ratio, 2.35; 95% confidence interval, 1.22 to 4.51; P = .01). Abdominal pain 24 hours after surgery was less severe in the no drain group (standardized mean difference, 2.30; 95% confidence interval, 1.27 to 3.34; P < .0001). No significant difference was present with respect to the presence and quantity of subhepatic fluid collection, shoulder tip pain, parenteral ketorolac consumption, nausea, vomiting, and hospital stay.Conclusion:This study was unable to prove that drains were useful in reducing complications in laparoscopic cholecystectomy.

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Section: Resultsmentioning

confidence: 98%