A controlled trial of drainage after cholecystectomy

Gordon, Angus B.; Bates, Tom; Fiddian, R V

doi:10.1002/bjs.1800630407

Cited by 43 publications

(18 citation statements)

References 8 publications

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“…Average age of presentation of cases of cholelithiasis was 44.5 years, comparable to various studies as reported 54, 47 and 45 years by Singh et al (2010), William et al (1972) 13 ; Gordan et al (1976) 14 and Danlel et al (1982) 15 respectively. It means that the disease is most common in the 5 th decade of life.…”

Section: Agesupporting

confidence: 82%

Extraction of Gallbladder Through Epigastric Port v/S Supraumbilical Port in Laparoscopic Cholecystectomy

Chand¹,

Kumar²,

Pahuja³

et al. 2017

jemds

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BACKGROUNDAim-Diseases of gallbladder are known since antiquity. Cholelithiasis has plagued the mankind for over 2000 years. Laparoscopic cholecystectomy is considered to be the procedure of choice for elective cholecystectomy. The operation of laparoscopic cholecystectomy is still evolving with time and the size, number of ports is reducing day by day. This prospective, randomised pilot study was done to compare the extraction of gallbladder through epigastric/subxiphoid port v/s supraumbilical port in laparoscopic cholecystectomy in terms of operative time, complications, extendibility of the incision, hospital stay, cosmesis, ease of use and acceptability by both the patient and surgeon.

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Section: Agesupporting

confidence: 82%

Extraction of Gallbladder Through Epigastric Port v/S Supraumbilical Port in Laparoscopic Cholecystectomy

Chand¹,

Kumar²,

Pahuja³

et al. 2017

jemds

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“…tThree Staph aureus (1, 1, 3); two Staph albus (0-5, 0-5); two Citrobacter (1, 20); one Acinetobacter (15); one Enterobacter (25). Of the 17 patients who developed wound sepsis, seven discharged pus from which no organism was grown.…”

Section: Resultsmentioning

confidence: 99%

Prophylactic use of cephazolin against wound sepsis after cholecystectomy.

Strachan¹,

Black²,

Powis³

et al. 1977

BMJ

159

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DiscussionNewborn infants of diabetic mothers are at risk of developing severe hypoglycaemia. Good control of maternal diabetes during pregnancy increases the fetal survival rate.3 Recent reports4 support the hypothesis that neonatal hypoglycaemia is due to islet-cell hyperplasia, which in turn may be caused in utero by maternal hyperglycaemia. Since perfect control of maternal blood glucose is aimed at during pregnancy, it is logical to avoid excessive stimulation of fetal insulin secretion immediately before delivery.5The combined infusion of insulin and glucose is a simple way of controlling the maternal blood glucose concentration during labour. It also permits adequate hydration of the mother and prevents starvation ketosis. At the same time the stomach may be kept empty, so that a general anaesthetic can be given without delay.Infused insulin is cleared extremely rapidly from the plasma, and by means of an insulin infusion the maternal plasma insulin concentration may be readily adjusted to achieve more-constant blood glucose concentrations. Immediately after delivery maternal insulin requirements fall, and the infusion rate of insulin may be lowered accordingly.Measurement of blood glucose with Dextrostix and the reflectance meter is simple and may be performed by nurses on capillary blood samples obtained by finger-prick at the bedside. The result is available within two minutes and compares favourably with estimations performed by a standard laboratory method. Repeated estimations may be performed without undue discomfort to the patient. (During one premature labour over 100 capillary blood samples were taken in 48 hours.)Provided that simple rules are observed and equipment is properly standardised, management of diabetes during labour with this method becomes a simple procedure suitable for all obstetric units.We thank Mr M Cameron for the obstetric care of these patients, and the labour ward staff and Sister Susan Judd and the house physicians of the medical unit for help with management of the infusions.

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“…Although less relevant in the laparoscopic era, drainage of Morison pouch following cholecystectomy (a clean-contaminated procedure) comprised the standard of care for a century since the procedure was first performed in 1882 [9,10]. Despite the frequency with which it was performed, controversy existed as to whether or not routine post-operative drainage following cholecystectomy was beneficial [10][11][12][13]. Although initial studies focused on the relationship between open drains and post-operative morbidity [11,12,14], as CSDs increased in usage, their effect on morbidity was examined similarly.…”

Section: Intra-abdominalmentioning

confidence: 99%

“…Despite the frequency with which it was performed, controversy existed as to whether or not routine post-operative drainage following cholecystectomy was beneficial [10][11][12][13]. Although initial studies focused on the relationship between open drains and post-operative morbidity [11,12,14], as CSDs increased in usage, their effect on morbidity was examined similarly.…”

Section: Intra-abdominalmentioning

confidence: 99%

A Multi-Disciplinary Review of the Potential Association between Closed-Suction Drains and Surgical Site Infection

Reiffel

Barie

Spector

2013

Surgical Infections

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Background: Despite the putative advantages conferred by closed-suction drains (CSDs), the widespread utilization of post-operative drains has been questioned due to concerns regarding both efficacy and safety, particularly with respect to the risk of surgical site infection (SSI). Although discipline-specific reports exist delineating risk factors associated with SSI as they relate to the presence of CSDs, there are no broad summary studies to examine this issue in depth. Methods: The pertinent medical literature exploring the relationship between CSDs and SSI across multiple surgical disciplines was reviewed. Results: Across most surgical disciplines, studies to evaluate the risk of SSI associated with routine postoperative CSD have yielded conflicting results. A few studies do suggest an increased risk of SSI associated with drain placement, but are usually associated with open drainage and not the use of CSDs. No studies whatsoever attribute a decrease in the incidence of SSI (including organ/space SSI) to drain placement. Conclusions: Until additional, rigorous randomized trials are available to address the issue definitively, we recommend judicious use and prompt, timely removal of CSDs. Given that the evidence is scant and weak to suggest that CSD use is associated with increased risk of SSI, there is no justification for the prolongation of antibiotic prophylaxis to ''cover'' an indwelling drain.

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A controlled trial of drainage after cholecystectomy

Cited by 43 publications

References 8 publications

Extraction of Gallbladder Through Epigastric Port v/S Supraumbilical Port in Laparoscopic Cholecystectomy

Extraction of Gallbladder Through Epigastric Port v/S Supraumbilical Port in Laparoscopic Cholecystectomy

Prophylactic use of cephazolin against wound sepsis after cholecystectomy.

A Multi-Disciplinary Review of the Potential Association between Closed-Suction Drains and Surgical Site Infection

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