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The role of abdominal drainage to prevent of intra-abdominal complications after laparoscopic cholecystectomy for acute cholecystitis: prospective randomized trial

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Abstract

Background

Routine drainage of the abdominal cavity after surgery has been a robust dogma for many decades. Nevertheless, the policy of routine abdominal drainage is increasingly questioned. Many surgeons believe that routine drainage after surgery may prevent postoperative intra-abdominal infection. The goal of this study was to assess the role of drains in laparoscopic cholecystectomy (LC) for acute cholecystitis.

Materials and methods

From May 2008 to July 2012, 160 patients that underwent LC due to acute cholecystitis at Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea, were enrolled in this study. After surgery, patients were randomly allocated to undergo drain placement in the subhepatic space (Group A) or no drainage (Group B).

Results

There was no significant difference in the intra-abdominal abscess rate, which was 0.0 % with Group A and 1.3 % with Group B (P = 0.319). The median subhepatic fluid collection was 4.1 mL (1.1–60 mL) in Group A and 4.5 mL (1.1–80.0 mL) in Group B (P = 0.298). However, the median hospital stay was 2 days (1–4 days) in Group B and 3 days (2–7 days) in group A (P = 0.001). The subgroup of empyema patients did not have any significant differences in intra-abdominal fluid collection or intra-abdominal abscess rate.

Conclusions

This study suggests that postoperative routine drainage of the abdominal cavity for acute cholecystitis does not prevent intra-abdominal infections.

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References

  1. Monson JRT, Guillou PJ, Keane FBV, Tanner WA, Brennan TG (1991) Cholecystectomy is safer without drainage—the results of a prospective, randomized clinical-trial. Surgery 109:740–746

    CAS  PubMed  Google Scholar 

  2. Kim J, Lee J, Hyung WJ, Cheong JH, Chen J, Choi SH, Noh SH (2004) Gastric cancer surgery without drains: a prospective randomized trial. J Gastrointest Surg 8:727–732

    Article  PubMed  Google Scholar 

  3. Heslin MJ, Harrison LE, Brooks AD, Hochwald SN, Coit DG, Brennan MF (1997) Is intra-abdominal drainage necessary after pancreaticoduodenectomy? Gastroenterology 112:A1448–A1448

    Article  Google Scholar 

  4. Hoffmann J, Shokouh-Amiri MH, Damm P, Jensen R (1987) A prospective, controlled study of prophylactic drainage after colonic anastomoses. Dis Colon Rectum 30:449–452

    Article  CAS  PubMed  Google Scholar 

  5. Gurusamy KS, Samraj K, Mullerat P, Davidson BR (2007) Routine abdominal drainage for uncomplicated laparoscopic cholecystectomy. Cochrane Database Syst Rev (4):CD00604

  6. Allemann P, Probst H, Demartines N, Schafer M (2011) Prevention of infectious complications after laparoscopic appendectomy for complicated acute appendicitis-the role of routine abdominal drainage. Langenbeck Arch Surg 396:63–68

    Article  Google Scholar 

  7. Piper HG, Derinkuyu B, Koral K, Perez EA, Murphy JT (2011) Is it necessary to drain all postoperative fluid collections after appendectomy for perforated appendicitis? J Pediatr Surg 46:1126–1130

    Article  PubMed  Google Scholar 

  8. Lau H, Lo CY, Patil NG, Yuen WK (2006) Early versus delayed-interval laparoscopic cholecystectomy for acute cholecystitis: a metaanalysis. Surg Endosc 20:82–87

    Article  CAS  PubMed  Google Scholar 

  9. Gurusamy KS, Samraj K (2007) Routine abdominal drainage for uncomplicated open cholecystectomy. Cochrane Database Syst Rev (2):CD00603

  10. Picchio M, De Angelis F, Zazza S, Di Fillippo A, Mancini R, Pattaro G, Stipa F, Adisa AO, Marino G, Spaziani E (2012) Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial. Surg Endosc 26:2817–2822

    Article  PubMed  Google Scholar 

  11. O’Connor TW, Hugh TB (1979) Abdominal drainage: a clinical review. Aust N Z J Surg 49:253–260

    Article  PubMed  Google Scholar 

  12. Wittmann DH, Schein M, Condon RE (1996) Management of secondary peritonitis. Ann Surg 224:10–18

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Wright NB, Williamson VC (1994) Ultrasound findings following laparoscopic cholecystectomy. Br J Radiol 67:429–430

    Article  CAS  PubMed  Google Scholar 

  14. Farrell TA, Geraghty JG, Keeling F (1993) Abdominal ultrasonography following laparoscopic cholecystectomy—a prospective-study. Clin Radiol 47:111–113

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We appreciate the statistical assistance of Kyung Hwa Han, MS. Biostatistical Collaboration Unit, Medical Research Center, Yonsei University College of Medicine.

Disclosures

Drs. Joon Seong Park, Joo Hee Kim, Jae Keun Kim, and Dong Sup Yoon have no conflict of interests or financial ties to disclose.

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Correspondence to Joon Seong Park.

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Park, J.S., Kim, J.H., Kim, J.K. et al. The role of abdominal drainage to prevent of intra-abdominal complications after laparoscopic cholecystectomy for acute cholecystitis: prospective randomized trial. Surg Endosc 29, 453–457 (2015). https://doi.org/10.1007/s00464-014-3685-5

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  • DOI: https://doi.org/10.1007/s00464-014-3685-5

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