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Related Experiment Video

Updated: Apr 27, 2026

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
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Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture

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Routine versus no drain placement after elective laparoscopic cholecystectomy: meta-analysis of randomized controlled

S Antoniou1, O Koch, G Antoniou

  • 1Center for Minimally Invasive Surgery Neuwerk Hospital, Mönchengladbach, Germany - stavros.antoniou@hotmail.com.

Minerva Chirurgica
|June 28, 2014
PubMed
Summary

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Routine surgical drains after laparoscopic cholecystectomy increase postoperative pain and morbidity. This meta-analysis found no benefit in preventing bile leaks, suggesting drains are unnecessary for uncomplicated procedures.

Area of Science:

  • Surgical outcomes
  • Gastrointestinal surgery
  • Evidence-based medicine

Background:

  • Routine drainage of the subhepatic space is a common practice after open cholecystectomy, continued in laparoscopic surgery without strong evidence.
  • The primary rationale for drainage is to prevent bile leakage, a potentially severe complication.

Purpose of the Study:

  • To compare the outcomes of routine drain placement versus no drainage after laparoscopic cholecystectomy.
  • To evaluate the impact on postoperative pain, subhepatic collections, morbidity, and wound complications.

Main Methods:

  • A meta-analysis of six randomized controlled trials involving 1167 patients.
  • Outcomes analyzed included pain scores, subhepatic collections, 30-day morbidity, and wound complications.
  • Fixed- and random-effects models were used to calculate pooled effect sizes.

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Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
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Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision

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908

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Last Updated: Apr 27, 2026

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
04:02

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture

Published on: November 25, 2025

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Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
05:36

Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision

Published on: May 2, 2025

908

Main Results:

  • Patients with drains experienced significantly higher postoperative pain at 6-12h and 12-24h.
  • No significant difference was observed in the incidence of subhepatic collections or the need for drainage interventions.
  • A trend towards lower 30-day morbidity and wound infection favored the no-drain approach.

Conclusions:

  • Routine drain placement after uncomplicated laparoscopic cholecystectomy is not supported by current evidence.
  • The practice leads to increased postoperative pain and overall morbidity.
  • Larger studies are needed, but current analysis does not encourage routine drainage.