Is routine drain insertion after laparoscopic cholecystectomy for acute cholecystitis beneficial? A multicenter, prospective randomized controlled trial

Kim, Eun Young; Lee, Soo Ho; Lee, Jun Suh; Yoon, Young Chul; Park, Sung Kyun; Choi, Ho Joong; Yoo, Dong Do; Hong, Tae Ho

doi:10.1002/jhbp.244

Cited by 24 publications

(38 citation statements)

References 19 publications

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“…Kim et al 58 , Kim et al 59 1.96-3.63% Any complications of the trocar sites, with erythema or tenderness that required opening, drainage or antibiotic therapy (hematoma or seroma was not included).…”

Section: Discussionmentioning

confidence: 99%

Reporting of complications after laparoscopic cholecystectomy: a systematic review

Alexander

Bartlett

Wells

et al. 2018

HPB

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Section: Discussionmentioning

confidence: 99%

Reporting of complications after laparoscopic cholecystectomy: a systematic review

Alexander

Bartlett

Wells

et al. 2018

HPB

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“…A flow diagram for study inclusion and exclusion is presented in Figure 1. The initial searches generated 585 citations, of which 3 studies [10][11][12] considered to be suitable for the final meta-analysis using the stated eligibility criteria. A total of 382 patients (188 drained versus 194 non-drain patients in emergency LC).…”

Section: Search Results and Reporting Qualitymentioning

confidence: 99%

“…Heterogeneity was not statistically significant (I 2 =0, P=0.81). Abdominal pain: Two studies [10,11] provided information about the 24 h postoperative abdominal pain. Abdominal pain 24 h after surgery was less severe in the no drain group (MD=0.80, 95% CI 0.47-1.14; P<0.00001) ( Figure 5).…”

Section: Huang/ying/jiamentioning

confidence: 99%

“…Third, the characteristics of included patients were not consistent among studies leading to some heterogeneity in our overall analyses. In the study of Kim [10], the patients were composed of acute edematous cholecystitis, gallbladder empyema and even gallbladder gangrene. However, patients were excluded if they were gangrenous or emphysematous cholecystitis in the study of Lucarelli [11].…”

Section: Drainage Versus No Drainage After Laparoscopic Cholecystectomentioning

confidence: 99%

“…Nevertheless, some surgeons advocate that drainage of the abdominal cavity has no advantage for detecting bile leakage or bleeding, and it is not helpful for preventing postoperative morbidities. Recently, some studies [9][10][11][12] have indicated that routine drainage is not needed to prevent postoperative after surgery for acutely inflamed gallbladder. There is no solid evidence to support routine abdominal drainage after LC for acute cholecystitis.…”

Section: Introductionmentioning

confidence: 99%

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Drainage versus no drainage after laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis

Huang¹,

Ying²,

Jia³

2019

biomedicalresearch

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Objective: To conduct a Randomized Controlled Trial (RCT) meta-analysis to assess the effectiveness of drains in reducing complications after Laparoscopic Cholecystectomy (LC) for acute cholecystitis. Methods: An electronic search of PubMed, EMBase, Science Citation Index, and the Cochrane Library from January 1990 to January 2016 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in LC for acute cholecystitis. The outcomes were calculated as Odds Ratios (ORs) with 95% Confidence Intervals (CIs) using RevMan 5.2. Results: Three RCTs, which included 382 patients, were identified for analysis in our study. There was no statistically significant different in the rate of morbidities (OR=1.23, 95% CI 0.55-2.76, P=0.61). Abdominal pain 24 h after surgery was more severe in the drain group (MD=0.80, 95% CI 0.47-1.14; P<0.00001). No significant difference was present with respect to wound infection rate and hospital stay. Conclusion: Placement of drain is not beneficial for the prevention or reduction of postoperative morbidities after emergent laparoscopic cholecystectomy and can even increase postoperative pain.

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Gram staining of gallbladder bile samples is useful for predicting surgical site infection in acute cholecystitis patients undergoing an early cholecystectomy

Nishida

Otagiri

Yoshifuku

et al. 2020

J Hepato Biliary Pancreat

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Acute cholecystitis (AC) is one of the most frequently encountered diagnoses in the emergency room, with its prevalence increasing worldwide. 1-3 The recommended treatment is an early cholecystectomy, which ought to be performed close to the time of the disease onset. 1 A common complication after cholecystectomy for AC is surgical site infection (SSI); its rate has been reported to be almost 10 percent. 4 For the prevention and control of such infection, multimodal strategies and multidisciplinary efforts are needed. The microbiological assessment of gallbladder bile is essential for management in AC patients. 5 Usually, a bacterial culture profile is used for SSI management; however,

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Is routine drain insertion after laparoscopic cholecystectomy for acute cholecystitis beneficial? A multicenter, prospective randomized controlled trial

Abstract: Routine drain insertion does not prevent or reduce postoperative morbidities after LC for AIGB and can even cause prolonged postoperative pain. This prospective study suggests that routine drain use in LC for AIGB should be reconsidered.

Cited by 24 publications

References 19 publications

Reporting of complications after laparoscopic cholecystectomy: a systematic review

Reporting of complications after laparoscopic cholecystectomy: a systematic review

Drainage versus no drainage after laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis

Gram staining of gallbladder bile samples is useful for predicting surgical site infection in acute cholecystitis patients undergoing an early cholecystectomy

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