Tube drainage versus without drain laparoscopic cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy (LC) is the gold standard for the surgical treatment of cholelithiasis. Routine intra-abdominal drainage after elective LC is an issue of considerable debate. Objecti ve: To evaluate the advantages and disadvantages of intra peritoneal drain insertion in patients undergoing Laparoscopic cholecystectomy. Patient and Methods : We conducted this study at the surgical ward of Al-khadhmy ia teaching hospital in the period fro m the 1 st of September 2019 to the end of January 2020.A co mparison betweenintra-abdominal drainage cholecystectomy fro m withoutdrainage cholecystectomy was made based on a study in 60 randomly chosen cases underwent elective LC for sy mptomatic gall stonePatients were divided before surgical procedure into two groups. Group A includes 30 patients in whom a drain was placed in subhepatic space and group B consisted 30 patients without drain. Postoperative pain, nausea vomit ing and discomfort, hospital stay and surgical site infect ionall were assessed, in addition the two groups were evaluated and compared regarding other possible postoperativecomplications.ResultsAll the cases in this study was elective uncomplicated laparoscopic cholecystectomy. 60 cases with age range fro m 17-74 years were included in the study, twenty eight (93.3%) patients in group A had pain at the drain site after 24th hours and the pain was persisting in 25 (83.33%) patients even at 48th hour after surgery. While in group B nineteen (63.33%) patients had pain at port sites after 24th and 10(33.33%) patients had pain at 48th hour after surgery. The pain was higher in group A by more than two points on the average in VAS (Visual Analogue Scale) at 24 and 48 hours. Postoperative complications were more frequently seen in Group A. Pain in the right shoulder was more o ften observed in Group B.Nausea, vomit ing was more co mmon in Group A. Nine patient had superficial wound infection of the epigastric port in the postoperative period in Group A while no one in group B. The hospital stay was obviously longer in drain g roup than non-drain one 2-4 / 1-2 days subsequently.ConclusionThe routine drainage of gallbladder bed after elective laparoscopic cholecystectomy may not be justified and appears to cause more postoperative pain and more postoperative complications and prolongs the hospital stay.

Drainage versus no drainage after laparoscopic cholecystectomy: A prospective randomized study

“…Patients who remained longer than a day reported feeling sick and resumed taking their food by mouth after two days. Hospitalization duration was greater for those who had drainage (1-4 days) compared to those who did not (1-2 days), as reported by Bashar et al [13] Patients were released from the hospital in the study by Rathi et al [8] after it was determined that their overall health was sufficient, and they had commenced oral intake. Patients who did not need drains spent an average of 2.1 days in the hospital, whereas those who did required a longer 3.58 days.…”

“…Infection at the incision site was five times more likely in the drain group, according to Cruse and Food's research [11,12] . In the postoperative period, nine patients in the drainage group and none in the non-drainage group had a superficial wound infection of the epigastric port [13] .…”