Predictive Factors for Drain Placement After Laparoscopic Cholecystectomy.

Area of Science:

• Minimally Invasive Surgery
• Surgical Outcomes Research
• Gastrointestinal Surgery

Background:

• Surgical drains are selectively used in laparoscopic cholecystectomy (LC).
• Previous evidence on drain non-benefit is limited by heterogeneous patient populations.
• Identifying specific patient groups for drain use is crucial.

Purpose of the Study:

• To identify clinical, demographic, and intraoperative factors predicting surgical drain placement in LC.
• To establish criteria for selecting patients for drain use.
• To inform the design of prospective randomized trials.

Main Methods:

• Retrospective analysis of 409 unconverted LC procedures (2014-2018).
• Patients divided into drain (Group A) and no-drain (Group B) groups.
• Exploration of baseline, preoperative, and intraoperative characteristics.

Main Results:

• 22% of patients received a surgical drain.
• Univariate analysis identified age, male sex, cholecystitis, Charlson Comorbidity Index (CCI) ≥ 1, surgeon experience, technical difficulties, additional trocar use, operative time, and blood loss as predictors.
• Multivariate analysis confirmed cholecystitis (OR: 2.8), CCI ≥ 1 (OR: 1.9), technical difficulties (OR: 3.6), additional trocar (OR: 2.5), and blood loss >10 ml (OR: 3.0) as significant predictors.

Conclusions:

• Specific factors currently influence surgeon decisions for drain placement post-LC.
• Further randomized prospective studies are necessary to definitively establish the role of drains in selected LC patients.