Related Experiment Videos
[Is there any indication for inserting a drain in elective laparoscopic cholecystectomy?]
Jaime Ruiz-Tovar1, Irene Ortega, Jair Santos
1Servicio de Cirugía General, Hospital General Universitario de Elche, Alicante, España. jruiztovar@gmail.com
Cirugia Espanola
|April 10, 2012
Summary
Routine sub-hepatic drains after laparoscopic cholecystectomy offer no benefit. Inserting a drain increases post-surgical pain and prolongs hospital stay without preventing complications like abscesses.
Area of Science:
- Gastroenterology and Surgical Innovation
- Minimally Invasive Surgery Techniques
Context:
- Traditionally, sub-hepatic drains were routinely used after cholecystectomy to mitigate risks such as intra-abdominal abscesses, bleeding, and biliary fistulas.
- Current evidence suggests routine drain placement offers no significant advantage and may be reserved for specific intraoperative findings.
Purpose:
- To evaluate the clinical utility of routine sub-hepatic drain insertion in elective laparoscopic cholecystectomies.
- To assess the impact of drain placement on postoperative pain, hospital stay, and complication rates.
Summary:
- A prospective study of 100 laparoscopic cholecystectomies found no benefit from routine sub-hepatic drain insertion.
- Patients receiving a drain experienced increased pain scores and a longer hospital stay (median increase of 1 day).
- Drain insertion did not prevent intra-abdominal abscesses in this cohort.
Impact:
- Findings challenge the routine practice of sub-hepatic drain placement in elective laparoscopic cholecystectomy.
- Suggests that drain use should be selective, based on specific intraoperative conditions and surgeon experience.
- Highlights potential negative impacts of drains on patient recovery, including increased pain and extended hospitalization.
