Is a Drain Required after Laparoscopic Cholecystectomy?

Gürer, Ahmet; Dumlu, Ersin Gürkan; Dikili, Erol; Kıyak, Gülten; Özlem, Nuraydın

doi:10.5152/eajm.2013.37

Cited by 11 publications

(6 citation statements)

References 20 publications

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“…However, controversies have surrounded this practice. 8,9 Mean hospital stay of patients in the group without drainage was less in our study, which is similar to the studies conducted by Gurusamy et al 10 and Satinsky et al 11 Patients complain of postoperative shoulder pain, nausea and vomiting, due to use of a shortterm drain postoperatively based on the theory that high-pressure CO2 insufflation during the operation and the accumulation of gas in the right subphrenic area leads to these complaints. [3][4][5][6] The results showed no significant differences in postoperative complications in the two groups (with and without drain) i.e., wound infections, mortality, respiratory infection and/or nausea.…”

Section: Discussionsupporting

confidence: 90%

Post-procedural Drainage versus no Drainage in Laparoscopic Cholecystectomy at DHQ Hospital Charsadda, Pakistan

Bilal

Aslam²,

din

et al. 2021

J Islamabad Med Dental Coll

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Background: Laparoscopic cholecystectomy (LC) is the treatment of choice for symptomatic gall stones but controversy regarding the routine use of drainage after elective LC still exists. The objective of this study was to determine the efficacy of post-procedural drainage versus no drainage after simple laparoscopic cholecystectomy. The postoperative complications were also evaluated in both groups after the LC procedure.Material and Methods: This Randomized controlled trial (RCT) was conducted in patients who underwent Laparoscopic cholecystectomy according to a pre-set inclusion criterion. Ninety-three patients were randomly assigned into group A (with drainage tube) and group B (without drainage tube) using sealed opaque envelopes containing computer‐generated random numbers. Primary (like duration of hospital stay, Postoperative pain) and secondary outcomes (like postoperative complications) were noted in both groups. Chi-square, Fischer exact test and Mann witney U test were applied as appropriate and statistical significance was established at P < .05.Results: The number of patients with hospital stay exceeding two days were more in group A (n=23; 51.1%) than B (n=13; 28.8%) (P < .05). Group A presented with more postoperative complications but differences between the two groups were statistically non-significant. Both Groups experienced a high level of pain at six hours of surgery followed by progressive decrease in severity at 24 and 48 hours, respectively (P=.06).Conclusions: Post-procedural drain placement after laparoscopic cholecystectomy has no advantages as there is no significant difference in post-operative complications and duration of hospital stay in drainage versus no drainage groups.

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Section: Discussionsupporting

confidence: 90%

Post-procedural Drainage versus no Drainage in Laparoscopic Cholecystectomy at DHQ Hospital Charsadda, Pakistan

Bilal

Aslam²,

din

et al. 2021

J Islamabad Med Dental Coll

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show abstract

“…Post-operative subhepatic collection: In this study, we found that overall 66.67% of cases were female & 33.33% cases were male. Similar sex preponderance in favour of females was observed by Dumlu et al [9] in their study with 5:1 (F: M ratio). The study done by Aman Nagpal et al [7] also showed the male female ratio as 1:3.…”

Section: Discussionsupporting

confidence: 89%

A Comparative Study Between Routine Insertions of Subhepatic Drain Versus No Drain After Elective Laparoscopic Cholecystectomy

Sarkar

2020

Global Journal for Research Analysis

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Introduction: Laparoscopic cholecystectomy is the mainstay of treatment in symptomatic cholelithiasis. Surgeons are still following the old habit of routine Subhepatic drainage following laparoscopic cholecystectomy (LC). However, routine drainage after LC is still a debatable issue. This study aims at evaluating the effects of Subhepatic drainage after standard laparoscopic cholecystectomy in terms of various post-operative parameters. Materials & methods: The study was conducted at the department of General Surgery, ESIC-PGIMSR, Joka, Kolkata from January 2018 to March 2020. We selected 120 patients with symptomatic cholelithiasis & divided them into 2 groups; each having 60 patients, with drain & without drain respectively. Age & sex distribution of the patients, post-operative abdominal pain & right shoulder tip pain, post-operative wound infection, subhepatic collection (24 & 72 hrs after surgery) & post-surgical hospital stay were measured in both groups. Data were analyzed by appropriate statistical tests. Results: We found the incidence of laparoscopic cholecystectomy was highest in the 5th decade & more common in women. The incidence of post-surgical abdominal pain & subhepatic collection were greater in the group of patients with drain in situ which was statistically significant also. Moreover, inserting drain showed increased incidence of post operative wound infection & hospital stay, though these were statistically insignificant. More patients in the non drain group showed post-operative right shoulder tip pain in comparison to the drain group but that was also statistically insignificant. Conclusion: The decision of inserting drain should be taken judiciously on the basis of individual case scenario. The generalized approach of putting abdominal drain after every standard laparoscopic cholecystectomy is not at all beneficial.

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“…Statistically and from previous studies, there is no correlation between fluid collection post LC or by the conventional method [ 22 - 23 ]. Limited data are available on the outcome of abdominal collection in a port site infection after dry mopping versus saline irrigation post biliary spillage.…”

Section: Discussionmentioning

confidence: 95%

Dry Mopping vs. Saline Irrigation of Gallbladder Fossa After Bile Spillage During Laparoscopic Cholecystectomy: Randomized Control Trial

Bhatti¹,

Ahmad²

2021

Cureus

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Introduction The laparoscopic approach, as compared to open cholecystectomy, is still considered the gold standard, despite a higher incidence of micro insults. The most common approach to treat spilled biliary contents and lost stones in laparoscopic cholecystectomy is the retrieval of the stone through an open approach, or laparoscopically, ending with a peritoneal wash and aspiration. Material and methods We conducted a double-blinded randomized controlled trial. In the study group, patients with bile spillage during cholecystectomy underwent suction of all spilled bile and evacuation of all visible stones followed by dry mopping of the gallbladder fossa with gauze swab through an epigastric port. In the control group, after suction of all bile and visible stones, the gallbladder fossa was washed with 250 ml of saline, and fluid was aspirated through the epigastric port. Results Sixty patients were included (30 patients in each group), 71.6% were female and the rest were male. There was a statistically significant difference in pain scores between the two groups (p=0.001). The dry mopping group had lower pain scores as compared to the other group postoperatively. The incidence of the intraabdominal collection in both groups are statistically insignificant, however, port site infection and intraabdominal collection are higher in the control group (irrigation group). Conclusion Although there is not much literature on the best approach to biliary spillage in laparoscopic cholecystectomy. We believe that dry mopping had better postoperative patient outcome as compared to the saline wash.

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Is a Drain Required after Laparoscopic Cholecystectomy?

Cited by 11 publications

References 20 publications

Post-procedural Drainage versus no Drainage in Laparoscopic Cholecystectomy at DHQ Hospital Charsadda, Pakistan

Post-procedural Drainage versus no Drainage in Laparoscopic Cholecystectomy at DHQ Hospital Charsadda, Pakistan

A Comparative Study Between Routine Insertions of Subhepatic Drain Versus No Drain After Elective Laparoscopic Cholecystectomy

Dry Mopping vs. Saline Irrigation of Gallbladder Fossa After Bile Spillage During Laparoscopic Cholecystectomy: Randomized Control Trial

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