[Cholecystectomy without drainage]

The authors report the results of cholecystectomies, with and without drainages performed at the Arnulfo Arias Madrid Metropolitan Medical Complex from May 1986 to May 1990. There were 150 patients in each group. The patients who were not drained (87%) were women, had fever less frequently and, on the average, for not more than 24 hours, whereas in the group with drainage more patients (54%) had fever, which lasted from one to three days. Eighty three per cent of the patients without drainage ate a regular meal within the first 24 hours after the operation and only 31% of those drained were able to do so. Forty six per cent of the patients without drainage were able to leave the hospital on the second, and 34%, on the third post operative day. Only 23% of the patients with drainage were able to leave the hospital on the third, and 35%, on the fourth post operative day. The authors conclude that drainage with cholecystectomy should be used selectively and only in patients with empyema of the gallbladder, pericholecystic abscess, perforation of the gallbladder, persisting bleeding, failure to remove the gallbladder because of severe inflammatory reaction and damage to the gallbladder bed.