Drainage versus no Drainage after Elective Laparoscopic Cholecystectomy

Background Laparoscopic cholecystectomy is the gold standard for the surgical treatment of cholelithiasis. Routine drainage after elective LC is an issue of considerable debate. Objective To evaluate the advantages and disadvantages of drainage in patients undergoing Laparoscopic cholecystectomy. Method The study was conducted at the department of surgery in Nepalgunj Medical College and Teaching Hospital, Kohalpur between March 2013 and May 2014. During the period of study, sixty patients underwent laparoscopic cholecystectomy for symptomatic gall stone. Sixty patients were randomized before surgical procedure into two groups. Group A consisted 30 patients in whom a drain was placed in subhepatic space and group B consisted 30 patients without drain. Postoperative pain was assessed using a 10-point visual analog scale. The two groups were evaluated and compared regarding postoperative pain, the time needed for surgery, length of postoperative hospital stay and the incidence of postoperative complications. Result The mean operative time in group A was 6.16 minutes longer when compared with group B (p>0.05). Although the postoperative mean pain score was same at 6 hours after surgery in both groups (7.53 vs 7.23), the postoperative pain was higher in the group A by more than two points on the average in VAS (visual analogue score) at 24 hours and 48 hours. The proportion of the patients staying in the hospital for more than two days was higher in group A, 14 (46.66%) and 8 (26.66%) in group B (p < 0.05). There was no statistical difference in the rate of wound infections, shoulder pain, nausea, vomiting, and respiratory infections between the two groups. Conclusion The routine drainage of gallbladder bed after elective laparoscopic cholecystectomy may not be justified and appears to cause more postoperative pain and more postoperative complications and prolongs the hospital stay.