Drain versus no drain in an uncomplicated elective laparoscopic cholecystectomy- an institutional study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20222861Keywords:
Drain, Hospital stay, Infection, Lap cholecystectomyAbstract
Background: Laparoscopic cholecystectomy (LC) is the gold standard for symptomatic gallstones. Post surgery to keep a subhepatic drain is an issue of debate. A randomised trial was designed to assess the outcome of drain in elective lap cholecystectomy.
Methods: A randomized control trial was done from January 2019 to June 2020 among 40 patients. They were randomised into group A: (n=20) in which subhepatic space was drained by an abdominal drain size 28F drain which was brought out through right anterior axillary port (even group) and group B: (n=20) in which there was no-drain at sub hepatic space (odd group). The end points of this study was to compare postoperative pain, fever, wound infection ,hospital stay between the two groups.
Results: Mean hospital stay among drain group was 3.95±1.35 days as compared to 2.55±0.60 days among no drain group and the difference was statistically significant (p value =0.001). 8 (40%) patients with drain had port side infection as compared to 1 (5%) patient among no drain group and the observed difference was statistically significant (p value =0.02). Post operative pain abdomen assessed using VAS, and found significant 12 after surgery. The young female patients were unhappy with the drain scar and 3 cases requested for need of plastic surgery corrections also.
Conclusions: The routine use of a drain in uncomplicated elective laparoscopic cholecystectomy has no benefit; in contrast, it is associated with longer hospital stay, so better to avoid the drain.
Metrics
References
Chalkoo M, Ahanger S. The historical perspective, current advancements and innovations in laparoscopic cholecystectomy. J Pak Med Stud. 2012;2(3):86-7.
National Institutes of Health (US). Office of Medical Applications of Research. Gallstones and laparoscopic cholecystectomy. Nat Inst Health Off Med Appl Res. 1992;10(3):1-20.
Litwin DE, Cahan MA. Laparoscopic cholecystectomy. Surg Clin North Am. 2008;88(6):1295-313.
Radunovic M, Lazovic R, Popovic N, Magdelinic M, Bulajic M, Radunovic L, et al. Complications of laparoscopic cholecystectomy: our experience from a retrospective analysis. Open Access Macedon J Med Sci. 2016;4(4):641-6.
Park JS, Kim JH, Kim JK. The role of abdominal drainage to prevent of intra-abdominal complications after laparoscopic cholecystectomy for acute cholecystitis: prospective randomized trial. Surg Endosc. 2015;29:453-7.
Wong CS, Cousins G, Duddy JC, Walsh SR. Intra-abdominal drainage for laparoscopic cholecystectomy: A systematic review and meta-analysis. Int J Surg. 2015;23(PtA):87-96.
Bostanci MT, Saydam M, Kosmaz K, Tastan B, Bostanci EB, Akoglu M. The effect on morbidity of the use of prophylactic abdominal drain following elective laparoscopic cholecystectomy. Pak J Med Sci. 2019;35(5):1306-11.
Nagpal A, Goyal S, Abbey L, Singh A. Drainage in cholecystectomy: required or not? A comparative randomized study in Northern Indian subjects. World J Laprosc Surg. 2012;5:63-6
Ishikawa K, Matsumata T, Kishihara F, Fukuyama Y, Masuda H, Kitano S. Laparoscopic cholecystectomy with and without abdominal prophylactic drainage. Digest Endosc. 2011;23:153-6.
El-Labban G, Hokkam E, El-Labban M, Saber A, Heissam K, El-Kammash S. Laparoscopic elective cholecystectomy with and without drain: a controlled randomised trial. J Minim Access Surg. 2012;8:90-2.
Halim A, Ahmad I, Iqbal J, Khan Z. Role of drain in laparoscopic cholecystectomy. J Med Sci. 2011;19:49-53.
Gurusamy KS, Samraj K. Routine abdominal drainage for uncomplicated open cholecystectomy. Cochrane Database Syst Rev. 2007;4:CD006004.
Picchio M, De Angelis F, Zazza S, Di Filippo A, Mancini R, Pattaro G, et al. Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial. Surg Endosc. 2012;26:2817-22.
Rathi PK, Shaikh AR, Kella N, Behan RB. Laparoscopic cholecystectomy without the use of drain in selected cases. JLUMHS. 2011;10(3):117-20.
Arslan K, Erenoğlu B, Atay A, Köksal H, Osman. Effect of drain localization on postoperative pain in laparoscopic cholecystectomy: prospective, randomized and controlled study. Eur J Surg Sci. 2012;3:86-91.
Downloads
Published
How to Cite
Issue
Section
