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Related Experiment Videos

Cholecystectomy: safe or not safe to drain?

S G Mellor1, M H Thomas, B S Donnellan

  • 1Department of Surgery, St Peter's Hospital, Surrey.

Journal of the Royal Society of Medicine
|October 1, 1988
PubMed
Summary

Routine surgical drains after cholecystectomy do not affect subhepatic fluid collection size. Drained patients experienced more complications, suggesting drainage is unnecessary and potentially dangerous.

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Area of Science:

  • Abdominal Surgery
  • Gastrointestinal Surgery
  • Surgical Complications

Background:

  • Subhepatic fluid collections are a potential complication after cholecystectomy.
  • The role of surgical drains in managing these collections and preventing complications is debated.

Purpose of the Study:

  • To investigate the influence of drains on subhepatic collection size post-cholecystectomy.
  • To assess the impact of drains on the incidence of clinical complications.

Main Methods:

  • Eighty-five patients undergoing cholecystectomy were randomized into three groups: no drain, narrow bore suction drain, or open corrugated drain.
  • Subhepatic fluid collections were measured using real-time ultrasound.
  • Fluid volumes drained and clinical complications were recorded.

Main Results:

  • Subhepatic collection sizes were similar regardless of drain use.
  • Drained fluid volumes exceeded measured collection volumes and did not predict biliary leakage.
  • Complication rates were higher in the drained group (28%) compared to the undrained group (10.5%).

Conclusions:

  • Surgical drainage following simple cholecystectomy appears unnecessary.
  • Open drains may increase the risk of complications, including biliary peritonitis.

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