Efficiency of Drainage after Cholecystectomy

Abstract

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.