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Routine abdominal drainage for uncomplicated laparoscopic cholecystectomy
K S Gurusamy1, K Samraj, P Mullerat
1Royal Free Hospital, Surgery, 291 Greenhaven Drive, Thamesmead, London, UK, SE28 8FY. kurinchi2k@hotmail.com
The Cochrane Database of Systematic Reviews
|July 20, 2007
Summary
Routine abdominal drainage after laparoscopic cholecystectomy for gallstones may reduce pain but increases wound infections and hospital stay. Evidence does not support routine drain use in this procedure.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Laparoscopic cholecystectomy is the standard treatment for symptomatic gallstones.
- Abdominal drains are commonly used post-procedure to prevent complications.
- However, drain use may lead to increased infections and prolonged hospital stays.
Purpose of the Study:
- To evaluate the benefits and harms of routine abdominal drainage.
- Focus on uncomplicated laparoscopic cholecystectomy procedures.
Main Methods:
- Systematic review of randomized clinical trials (RCTs).
- Searched multiple databases including Cochrane, MEDLINE, and EMBASE up to March 2007.
- Analyzed data on complications, pain, and hospital stay using fixed-effect and random-effects models.
Main Results:
- Five RCTs involving 591 patients were analyzed.
- Wound infection rates were higher in the drain group (OR 15.38).
- Drainage was associated with reduced pain and nausea, but longer hospital stays.
Conclusions:
- Routine drain use may decrease early post-operative pain.
- However, it is linked to increased wound infection rates and delayed discharge.
- Current evidence does not support the routine use of drains after laparoscopic cholecystectomy.
