The Role of Drainage Following Biliary Tract Surgery

Strohl, E. Lee; Diffenbaugh, Willis G.; Anderson, Raymond E.

doi:10.1016/s0039-6109(16)37207-3

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Occasionally, a large quantity of bile is drained after an apparently straightforward cholecystectomy which gradually stops without the need for re-exploration (Strohl et al, 1964), and it is presumably for this reason that the majority of surgeons (Lazarus et al, 1954;Carpenter et al, 1968) still routinely use a drain after cholecystectomy, in spite of the favourable results claimed for omitting drainage.…”

Section: Removal Of Drain Drainage Elective Drainagementioning

confidence: 99%

A controlled trial of drainage after cholecystectomy

Gordon

Bates

Fiddian

1976

British Journal of Surgery

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A prospective controlled trial of drainage after cholecystectomy has been carried out. In a consecutive series of 143 patients undergoing cholecystectomy, 50 patients were randomly allocated to a drainage group and a further 50 patients to a non-drainage group. The remaining 43 patients were drained electively because the common bile duct was explored or because of infection or incomplete haemostasis. There was no significant difference in the incidence of wound infection or other complications between the drainage and the non-drainage groups. The duration of postoperative pyrexia, the number of analgesic injections and the length of postoperative hospital stay were the same in both the randomized groups. One patient in the randomized drainage group had a reactionary haemorrhage from the drain site requiring transfusion. There was no mortality but one patient in the elective drainage group had to be re-explored for a subhepatic abscess. Three patients in this group drained bile from the drain for 3-9 days but all had a T tube in place. This trial fails to demonstrate any advantage or disadvantage in draining the gallbladder bed after cholecystectomy.

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Section: Removal Of Drain Drainage Elective Drainagementioning

confidence: 99%

A controlled trial of drainage after cholecystectomy

Gordon

Bates

Fiddian

1976

British Journal of Surgery

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“…6 Those who favor the use of drainage argue that bile is highly toxic and sometimes infected and therefore must be drained. [7][8][9] The drains may provide an early warning of hemorrhage, allowing the surgeons to intervene in time. 7,9 This is not as simple as it sounds, for nature attacks the drains as foreign bodies and obstructs their lumen by the very debris they are meant to remove.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] The drains may provide an early warning of hemorrhage, allowing the surgeons to intervene in time. 7,9 This is not as simple as it sounds, for nature attacks the drains as foreign bodies and obstructs their lumen by the very debris they are meant to remove. 4,10 This study shows that drains delay patient's discharge from the hospital.…”

Section: Discussionmentioning

confidence: 99%

Cholecystectomy without Drainage: A Controlled Clinical Trial

et al. 1989

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Drainage after cholecystectomy

Hoffmann

Lorentzen

1985

British Journal of Surgery

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Drainage after cholecystectomy In their paper on this subject (Annals, May 1982, vol. 64,p. 183) Messrs Ian Fraser, N W Everson, and J R Nash report a comparison of two cholecystectomy drainage methods in a randomised trial. We wish to take this opportunity to point out that the results of the trial should not be regarded as an appraisal of suction per se. The reason is simple. The trial compared suction drainage with passive (that is, static) drainage. The trial also made a comparison between drainage via two types of tube, one described as 'larger and more rigid' than the other. Thus two variables were involved in the comparison and there is no way of telling whether the differences which emerged should be ascribed to the difference in rigidity and size of the tubes or to the fact that suction was or was not applied. This is acknowledged by the authors and is apparent already from the title: 'A. .. trial of two drainage methods. .. ' With this in mind it is easier to understand why the results of the trial differ so much from those we obtained in a trial in which we tried to evaluate suction versus static drainage through the main wound versus a stab incision in a 2 by 2 design (1). In our comparison of suction versus static drainage the same medical grade polyvinyl chloride ester catheter was used with and without suction. In contrast to Fraser et al. we found that the amount of fluid drained was twice as large in patients with static drainage as in those with suction. Also in contrast to Fraser et al. we failed to detect a difference in the incidence of infection. The question submitted to a trial by Fraser et al. was practical in nature: what is the difference between drainage with Redivac bottle suction via a fine flexible tube on the one hand and static drainage using a more rigid 32-French Portex tube on the other? The question we submitted to a trial was: given a certain tube, what is the effect of suction? When questions are so different we cannot expect identical answers.

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The Role of Drainage Following Biliary Tract Surgery

Cited by 6 publications

References 15 publications

A controlled trial of drainage after cholecystectomy

A controlled trial of drainage after cholecystectomy

Cholecystectomy without Drainage: A Controlled Clinical Trial

Drainage after cholecystectomy

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