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Routine abdominal drainage for uncomplicated laparoscopic cholecystectomy
K S Gurusamy1, K Samraj, P Mullerat
1Royal Free and University College School of Medicine, University Department of Surgery, 9th Floor, Royal Free Hospital, Pond Street, London, UK, NW3 2QG. kurinchi2k@hotmail.com
The Cochrane Database of Systematic Reviews
|October 19, 2007
Summary
Routine abdominal drainage after laparoscopic cholecystectomy for gallstones increases wound infections and delays hospital discharge. Evidence does not support routine drain use in uncomplicated procedures.
Area of Science:
- Surgical Gastroenterology
- Minimally Invasive Surgery
- Evidence-Based Medicine
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, EMBASE until March 2007.
- Analyzed data on complications, pain, and hospital stay using meta-analysis.
Main Results:
- Six RCTs involving 741 patients were analyzed.
- Drainage group showed significantly higher wound infection rates (OR 5.86).
- Routine drainage was associated with longer hospital stays and reduced same-day discharges.
Conclusions:
- Routine drain use after elective laparoscopic cholecystectomy is linked to increased wound infections.
- Drainage also delays hospital discharge.
- Current evidence does not support the routine use of drains in these procedures.
