Cholecystectomy without drainage, nasogastric suction, and intravenous fluids

Man, Boris; Kraus, L; Motovic, A

doi:10.1016/0002-9610(77)90535-9

Cited by 23 publications

(3 citation statements)

References 6 publications

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“…understanding of the problems related to drains, especially in gallbladder surgery, there has been a swing towards non-utilization of drains [3,4]. Similar questions have been raised in thyroid surgery as to whether drains are essential in every patient undergoing thyroidectomy .…”

Section: Introductionmentioning

confidence: 99%

Selective use of drains in thyroid surgery

Shaha¹,

Jaffe²

1993

Journal of Surgical Oncology

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In the past, it was generally advised that every patient undergoing thyroid surgery have a drain placed because of the fear of post-operative hematoma. In the past 9 years, we have performed 400 thyroidectomies. For the first 6 years, we drained the operative site in most of thyroid procedures. However, it was apparent from our experience that drains had very little effect on the prevention of post-operative hematoma or of seroma. As a matter of fact, all four patients who required re-exploration in our initial series had drains in place. As a result of this experience over the past 3 years, during which time we have performed 150 thyroidectomies, we have used drains selectively. The indications for draining the thyroid bed have been the presence of a large dead space, operation for a large substernal goiter, and subtotal thyroidectomy for either large, multinodular goiter or for Graves' disease. Thus, among 150 recent thyroidectomies, we have drained only 35, and avoided drains in 115 patients. Though this is not a prospective study, we found no difference in the overall outcome whether drains were employed or not. Most patients who had no drains were ready for discharge within 24-48 hours of surgery. Since it may be difficult to perform a randomized prospective trial examining the use of drains in thyroid surgery, we propose that drains should be utilized only selectively for thyroid surgery.

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Section: Introductionmentioning

confidence: 99%

Selective use of drains in thyroid surgery

Shaha¹,

Jaffe²

1993

Journal of Surgical Oncology

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“…Recent reports have questioned the benefit of drains in biliary surgery. 1,[3][4][5] We have carried out a prospective study in which the patients were randomly allocated to no drainage or drainage groups. The aim was to determine whether or not the use of an intraperitoneal drain after cholecystectomy had any beneficial effect.…”

mentioning

confidence: 99%

Cholecystectomy without Drainage: A Controlled Clinical Trial

et al. 1989

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“…Thus, they use drain age only in those patients whose conditions indicate a need for it: acute cholecystitis, empyema, gangrene, per foration of the gallbladder, abscess formation, gross spillage of bile or infected material, common bile duct exploration, simultaneous performance of other intraab dominal procedures, incomplete hemostasis, evidence of bile leakage, injury and nonclosure of the gallbladder bed, pancreatitis, adhesions, inexperienced surgeon, or needle cholangiography of the common bile duct [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. There is indeed evidence that drains after elective chole cystectomy do increase the incidence of some postopera tive complications such as wound infections, fever, and respiratory problems and have some economic disad vantages [1,2,5,[7][8][9][10][12][13][14][15][16][17][18][19], But this has not been proven unequivocally in strictly comparable patient groups. All retrospective studies may have been biased in the sense that the more complicated cases were drained [20].…”

Section: Introductionmentioning

confidence: 99%

Efficiency of Drainage after Cholecystectomy

Schäfer¹,

Wedmann

Finke³

et al. 1988

Dig Surg

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In a prospective study of 108 patients after elective cholecystectomy the amount and character of silicone-tube-drained secretion was evaluated. Before and after removal of the drain tube the operative field was examined sonographically. About 85% of the postoperative secretion was drained during the first 48 h. As a drainage for blood and serous liquids and an early warning system for a bile leakage the drainage has terminated its function on the 3rd postoperative day. In 2 patients with secondary bleeding the drainage function was insufficient and thus misleading. In half of the patients subhepatic fluid collections, with a median of 15 ml, mostly in the area of the gallbladder, were detected sonographically on the 3rd-5th postoperative day with the drainage in place. The sonographic detection of the fluid could be correlated significantly to increased intraabdominal adhesions, perioperative fall of the hemoglobin and postoperative temperatures of > 38 °C. Closed silicone tube drainage systems are well suited for drainage after cholecystectomy. If inserted for a short period of 2–3 days, these drains do not lead to complications and, in about 50% of cases, are capable of draining the subhepatic space completely. Usually smaller subhepatic liquid collections are clinically insignificant. However, sonographic increase in fluid collection after removal of the drainage indicates a local postoperative complication.

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Cholecystectomy without drainage, nasogastric suction, and intravenous fluids

Cited by 23 publications

References 6 publications

Selective use of drains in thyroid surgery

Selective use of drains in thyroid surgery

Cholecystectomy without Drainage: A Controlled Clinical Trial

Efficiency of Drainage after Cholecystectomy

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