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Drainage versus no Drainage after Elective Laparoscopic Cholecystectomy
1Department of Surgery, Nepalgunj Medical College and Teaching Hospital, Kohalpur, Nepal.
Kathmandu University Medical Journal (KUMJ)
|November 29, 2016
Summary
Routine drainage after laparoscopic cholecystectomy (gallbladder removal) may not be beneficial. This surgical approach can increase postoperative pain and hospital stays without reducing complications.
Area of Science:
- Surgical Innovation
- Gastrointestinal Surgery
- Evidence-Based Medicine
Background:
- Laparoscopic cholecystectomy is the standard surgical treatment for gallstones.
- The necessity of routine surgical drainage following this procedure remains a topic of debate.
Purpose of the Study:
- To investigate the benefits and drawbacks of employing surgical drains after laparoscopic cholecystectomy.
Main Methods:
- A randomized controlled trial involving sixty patients undergoing laparoscopic cholecystectomy for symptomatic gallstones.
- Patients were divided into two groups: one with a subhepatic drain (Group A) and one without (Group B).
- Outcomes assessed included postoperative pain (Visual Analog Scale), operative time, hospital stay duration, and complication rates.
Main Results:
- Operative time was slightly longer in the drained group (Group A) but not statistically significant.
- While initial pain scores were similar, Group A reported significantly higher pain at 24 and 48 hours post-surgery.
- A higher proportion of patients in Group A (46.66%) required hospitalization longer than two days compared to Group B (26.66%).
- No significant differences were observed in wound infections, shoulder pain, nausea, vomiting, or respiratory infections between the groups.
Conclusions:
- Routine drainage of the gallbladder bed after elective laparoscopic cholecystectomy is not routinely justified.
- Implementing drains may lead to increased postoperative pain, prolonged hospital stays, and potentially more complications.
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