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Published on: March 10, 2023
Routine abdominal drainage for uncomplicated liver resection
K S Gurusamy1, K Samraj, B R Davidson
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 liver resections is not supported by evidence. Studies show no significant difference in outcomes between drain and no drain groups for uncomplicated procedures.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Gastroenterology
Background:
- Drains are used in liver resections to prevent fluid collections, monitor bleeding, and manage bile leaks.
- Concerns exist that drain placement may increase complication rates.
Purpose of the Study:
- To evaluate the benefits and harms of routine abdominal drainage in patients undergoing elective liver resections.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
- Searches included major databases (Cochrane Hepato-Biliary, CENTRAL, MEDLINE, EMBASE, Science Citation Index Expanded) until March 2007.
- Data on mortality, morbidity, and hospital stay were analyzed using fixed-effect and random-effects models.
Main Results:
- Five RCTs involving 465 patients compared drain versus no drain, with no significant differences in mortality, collections, infections, or hospital stay.
- One trial on drain types suggested closed drainage may reduce infected collections and chest complications compared to open drainage.
Conclusions:
- Current evidence does not support the routine use of drains after uncomplicated liver resections.
- Further research may be needed to clarify optimal drain management in specific patient populations.
