Routine abdominal drainage for uncomplicated open cholecystectomy

Gurusamy, Kurinchi Selvan; Samraj, Kumarakrishnan

doi:10.1002/14651858.cd006003.pub2

Cited by 36 publications

(21 citation statements)

References 34 publications

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“…(21) Randomized trials evaluating the use of routine drainage following other major abdominal surgery have also failed to demonstrate benefit, even suggesting an increased complication rate with drain placement following cholecystectomy. (22–25) …”

Section: Discussionmentioning

confidence: 99%

Technical factors associated with anastomotic leak after Roux–en–Y gastric bypass

Smith

Adeniji

Wahed

et al. 2015

Surgery for Obesity and Related Diseases

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Background Anastomotic leak is one of the most serious complications following Roux-en-Y gastric bypass (RYGB). Objective To examine the relationship between technical factors and incidence of clinically relevant anastomotic leak following RYGB in Longitudinal Assessment of Bariatric Surgery (LABS). Setting Eleven bariatric centers in the United States, University and Private Practice. Methods Patient characteristics, technical factors of surgery, and postoperative outcomes were assessed by trained researchers using standardized protocols. Correlation of surgical factors of patients undergoing RYGB (n=4444) with the incidence of post-operative anastomotic leak was assessed by univariate chi-squared analysis. Results Forty-four participants (1.0%, 95%CI 0.7% to 1.3%) experienced a clinically relevant anastomotic leak. Of these, 39 (89%) underwent abdominal re-operation and 3 (7%) died. Technical factors associated with anastomotic leak were open surgery (p<0.0001), revision surgery (p<0.0001) and use of an abdominal drain (p=0.02). Provocative leak testing, method of gastrojejunostomy and use of fibrin sealant were not associated with anastomotic leak. Conclusions Anastomotic leak following RYGB was rare (1.0%). Most cases required reintervention, however, the majority (93%) recovered from this event. Open surgery, revision surgery and routine drain placement were associated with increased leak rate. Some of these findings may be due to differences in pre-operative patient risk.

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Section: Discussionmentioning

confidence: 99%

Technical factors associated with anastomotic leak after Roux–en–Y gastric bypass

Smith

Adeniji

Wahed

et al. 2015

Surgery for Obesity and Related Diseases

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show abstract

“…Placement of intraabdominal drains has been demonstrated repeatedly to increase surgical wound infections [21][22][23], especially when left more than 3 days [24]. However, true intraabdominal infections specifically have not shown a well-documented association.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal inflammatory response of natural orifice translumenal endoscopic surgery (NOTES) versus laparoscopy with carbon dioxide and air pneumoperitoneum

et al. 2010

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The local inflammatory reaction to NOTES was similar to that with traditional laparoscopy, and the previously described late-phase systemic TNF-alpha depression in serum was not reproduced. At the peritoneal level, NOTES is no more physiologically stressful than laparoscopy. Furthermore, regardless of which gas was used, the role of the pneumoperitoneum agent did not affect the cytokine profile after NOTES, suggesting that air pneumoperitoneum is adequate for NOTES.

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“…Three of five meta-analyses (60%) [57][58][59] concerning biliary surgery compared the use of different types of drainage in various types of cholecystectomy with mixed results. The remaining meta-analyses (40%) 51,62 compared early with delayed laparoscopic cholecystectomy, in which no difference was found between the two techniques regarding complication rates.…”

Section: Meta-analyses Focusing On Topics Other Than Antibiotic Prophmentioning

confidence: 99%

Meta-analysis on Surgical Infections

Matthaiou¹,

Peppas²,

Falagas³

2009

Infectious Disease Clinics of North America

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Routine abdominal drainage for uncomplicated open cholecystectomy

Cited by 36 publications

References 34 publications

Technical factors associated with anastomotic leak after Roux–en–Y gastric bypass

Technical factors associated with anastomotic leak after Roux–en–Y gastric bypass

Peritoneal inflammatory response of natural orifice translumenal endoscopic surgery (NOTES) versus laparoscopy with carbon dioxide and air pneumoperitoneum

Meta-analysis on Surgical Infections

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