Skip to main content

Clinical significance of drainage tube insertion in laparoscopic cholecystectomy: a prospective randomized controlled trial

Journal of Hepato-Biliary-Pancreatic Surgery volume 14, pages 551–556 (2007)Cite this article

Abstract

Background/Purpose

We aimed to investigate the appropriateness of inserting an intraperitoneal drainage tube after laparoscopic cholecystectomy (LC), based on postoperative pain and clinical courses, in a randomized comparative study.

Methods

One hundred and twenty patients who were to have LC were enrolled in this prospective randomized study. An 8-mm Penrose drain was retained below the liver bed for 42 h in each of 60 patients (group A), and no drain was retained in the remaining 60 patients (group B). Patients in each group were hospitalized for 4 days after operation, and the pain reported by the patients, using a visual analogue pain scale (VAS), and the time courses of changes in the highest body temperature, leukocyte count, and C-reactive protein (CRP) were studied comparatively for men and women.

Results

Mean VAS scores were significantly greater in group A than in group B at 24 h (P = 0.00004), and 48 h (P = 0.0014) after operation. When sex-stratified changes in mean VAS scores were compared within group A, females had more pain than their male counterparts at 24 h (P = 0.030), but group B showed no sex differences. When the number of patients who used analgesics postoperatively was compared between groups A and B, analgesics were used more frequently in group A. When changes in maximum body temperature were compared, the change was significantly higher in group A than in group B on day 2 after the operation (P = 0.017).

Conclusions

Postoperative pain was intensified by the insertion of a drainage tube after LC. This tendency was stronger in women.

This is a preview of subscription content, access via your institution.

References

  1. K Uchiyama H Onishi M Tani H Kinoshita M Ueno H Yamaue (2004) ArticleTitleTiming of laparoscopic cholecystectomy for acute cholecystitis with cholecystolithiasis Hepatogastroenterology 51 346–8 Occurrence Handle15086155

    PubMed  Google Scholar 

  2. A Ota N Kano H Kusanagi S Yamada A Garg (2003) ArticleTitleTechniques for difficult cases of laparoscopic cholecystectomy J Hepatobiliary Pancreat Surg 10 172–5 Occurrence Handle14505152 Occurrence Handle10.1007/s00534-002-0825-4

    PubMed  Article  Google Scholar 

  3. Y Toyama R Miyake K Son S Yoshida T Usuba T Nojiri et al. (2006) ArticleTitleThree-Port laparoscopic partial hepatectomy using an ultrasonically activated device (USAD) J Hepatobiliary Pancreat Surg 13 317–22 Occurrence Handle16858543 Occurrence Handle10.1007/s00534-005-1071-3

    PubMed  Article  Google Scholar 

  4. L Sarli R Costi G Sansebastiano M Trivelli L Roncoroni (2000) ArticleTitleProspective randomized trial of low-pressure pneumoperitoneum for reduction of shoulder-tip pain following laparoscopy Br J Surg 87 1161–5 Occurrence Handle10971421 Occurrence Handle10.1046/j.1365-2168.2000.01507.x Occurrence Handle1:STN:280:DC%2BD3M%2Fjs1Oksg%3D%3D

    PubMed  Article  CAS  Google Scholar 

  5. A Vezakis D Davides JS Gibson MR Moore H Shah M Larvin MJ McMahon (1999) ArticleTitleRandomized comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy Surg Endosc 13 890–3 Occurrence Handle10449846 Occurrence Handle10.1007/s004649901127 Occurrence Handle1:STN:280:DyaK1MzotVKmug%3D%3D

    PubMed  Article  CAS  Google Scholar 

  6. E Perrakis A Vezakis G Velimezis G Savanis S Deverakis J Antoniades E Sagkana (2003) ArticleTitleRandomized comparison between different insufflation pressures for laparoscopic cholecystectomy Surg Laparosc Endosc Percutan Tech 13 245–9 Occurrence Handle12960786 Occurrence Handle10.1097/00129689-200308000-00004 Occurrence Handle1:STN:280:DC%2BD3svitFantQ%3D%3D

    PubMed  Article  CAS  Google Scholar 

  7. J Abbott J Hawe P Srivastava D Hunter R Garry (2001) ArticleTitleIntraperitoneal gas drain to reduce pain after laparoscopy: randomized masked trial Obstet Gynecol 98 97–100 Occurrence Handle11430964 Occurrence Handle10.1016/S0029-7844(01)01383-7 Occurrence Handle1:STN:280:DC%2BD3MznsValsw%3D%3D

    PubMed  Article  CAS  Google Scholar 

  8. K Uchiyama M Kawai H Onishi M Tani H Kinoshita M Ueno H Yamaue (2003) ArticleTitlePreoperative antimicrobial administration for prevention of postoperative infection in patients with laparoscopic cholecystectomy Dig Dis Sci 48 1955–9 Occurrence Handle14627340 Occurrence Handle10.1023/A:1026114203622

    PubMed  Article  Google Scholar 

  9. DJ Swank SC Swank-Bordewijk WC Hop WF van Erp IM Janssen HJ Bonjer J Jeekel (2003) ArticleTitleLaparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial Lancet 361 1247–51 Occurrence Handle12699951 Occurrence Handle10.1016/S0140-6736(03)12979-0 Occurrence Handle1:STN:280:DC%2BD3s7pvVamsA%3D%3D

    PubMed  Article  CAS  Google Scholar 

  10. BJ Ammori D Davides A Vezakis IG Martin M Larvin S Smith et al. (2003) ArticleTitleDay-case laparoscopic cholecystectomy: a prospective evaluation of a 6-year experience J Hepatobiliary Pancreat Surg 10 303–8 Occurrence Handle14598151 Occurrence Handle10.1007/s00534-002-0807-6

    PubMed  Article  Google Scholar 

  11. CY Yeh CR Changchien JY Wang JS Chen HH Chen JM Chiang R Tang (2005) ArticleTitlePelvic drainage and other risk factors for leakage after elective anterior resection in rectal cancer patients: a prospective study of 978 patients Ann Surg 241 9–13 Occurrence Handle15621985

    PubMed  Google Scholar 

  12. KC Conlon D Labow D Leung A Smith W Jarnagin DG Coit et al. (2001) ArticleTitleProspective randomized clinical trial of the value of intraperitoneal drainage after pancreatic resection Ann Surg 234 487–93 Occurrence Handle11573042 Occurrence Handle10.1097/00000658-200110000-00008 Occurrence Handle1:STN:280:DC%2BD3MrisFCqtw%3D%3D

    PubMed  Article  CAS  Google Scholar 

  13. CL Liu ST Fan CM Lo Y Wong IO Ng CM Lam et al. (2004) ArticleTitleAbdominal drainage after hepatic resection is contraindicated in patients with chronic liver diseases Ann Surg 239 194–201 Occurrence Handle14745327 Occurrence Handle10.1097/01.sla.0000109153.71725.8c

    PubMed  Article  Google Scholar 

  14. VL Wills DR Hunt (2000) ArticleTitlePain after laparoscopic cholecystectomy Br J Surg 87 273–84 Occurrence Handle10718794 Occurrence Handle10.1046/j.1365-2168.2000.01374.x Occurrence Handle1:STN:280:DC%2BD3c7otleqsw%3D%3D

    PubMed  Article  CAS  Google Scholar 

  15. M Barczynski RM Herman (2003) ArticleTitleA prospective randomized trial on comparison of low-pressure (LP) and standard-pressure (SP) pneumoperitoneum for laparoscopic cholecystectomy Surg Endosc 17 533–8 Occurrence Handle12582754 Occurrence Handle10.1007/s00464-002-9121-2 Occurrence Handle1:STN:280:DC%2BD3s7nvFGktQ%3D%3D

    PubMed  Article  CAS  Google Scholar 

  16. JF Larsen P Ejstrud JU Kristensen F Svendsen F Redke V Pedersen (2001) ArticleTitleRandomized comparison of conventional and gasless laparoscopic cholecystectomy: operative technique, postoperative course, and recovery J Gastrointest Surg 5 330–5 Occurrence Handle11360058 Occurrence Handle10.1016/S1091-255X(01)80056-1 Occurrence Handle1:STN:280:DC%2BD3MzjtlCrsQ%3D%3D

    PubMed  Article  CAS  Google Scholar 

  17. A Vezakis D Davides JS Gibson MR Moore H Shah M Larvin MJ McMahon (1999) ArticleTitleRandomized comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy Surg Endosc 13 890–3 Occurrence Handle10449846 Occurrence Handle10.1007/s004649901127 Occurrence Handle1:STN:280:DyaK1MzotVKmug%3D%3D

    PubMed  Article  CAS  Google Scholar 

  18. S Saad I Minor T Mohri M Nagelschmidt (2000) ArticleTitleThe clinical impact of warmed insufflation carbon dioxide gas for laparoscopic cholecystectomy Surg Endosc 14 787–90 Occurrence Handle11000355 Occurrence Handle10.1007/s004640010060 Occurrence Handle1:STN:280:DC%2BD3cvkvFGrug%3D%3D

    PubMed  Article  CAS  Google Scholar 

  19. DR Farley SM Greenlee DR Larson JR Harrington (2004) ArticleTitleDouble-blind, prospective, randomized study of warmed, humidified carbon dioxide insufflation vs standard carbon dioxide for patients undergoing laparoscopic cholecystectomy Arch Surg 139 739–43 Occurrence Handle15249406 Occurrence Handle10.1001/archsurg.139.7.739

    PubMed  Article  Google Scholar 

  20. CC Shen MP Wu CH Lu FT Kung FJ Huang EY Huang et al. (2003) ArticleTitleEffects of closed suction drainage in reducing pain after laparoscopic-assisted vaginal hysterectomy J Am Assoc Gynecol Laparosc 10 210–4 Occurrence Handle12732774 Occurrence Handle10.1016/S1074-3804(05)60301-5

    PubMed  Article  Google Scholar 

  21. D Bhattacharya PS Senapati R Hurle BJ Ammori (2002) ArticleTitleUrgent versus interval laparoscopic cholecystectomy for acute cholecystitis: a comparative study J Hepatobiliary Pancreat Surg 9 538–42 Occurrence Handle12541036 Occurrence Handle10.1007/s005340200070

    PubMed  Article  Google Scholar 

  22. K Uchiyama K Takifuji M Tani H Onishi H Yamaue (2002) ArticleTitleEffectiveness of the clinical pathway to decrease length of stay and cost for laparoscopic surgery Surg Endosc 16 1594–7 Occurrence Handle12085145 Occurrence Handle10.1007/s00464-002-9018-0 Occurrence Handle1:STN:280:DC%2BD38notlGhsQ%3D%3D

    PubMed  Article  CAS  Google Scholar 

  23. T Kagaya (2001) ArticleTitleLaparoscopic cholecystectomy via two ports, using the “Twin-Port” system J Hepatobiliary Pancreat Surg 8 76–80 Occurrence Handle11294293 Occurrence Handle10.1007/s005340170053 Occurrence Handle1:STN:280:DC%2BD3MvkslaqsA%3D%3D

    PubMed  Article  CAS  Google Scholar 

  24. E Caratozzolo A Recordare M Massani L Bonariol A Jelmoni M Antoniutti N Bassi (2005) ArticleTitleTelerobotic-assisted laparoscopic cholecystectomy: our experience on 29 patients J Hepatobiliary Pancreat Surg 12 163–6 Occurrence Handle15868084 Occurrence Handle10.1007/s00534-004-0932-5

    PubMed  Article  Google Scholar 

  25. N Akyurek O Irkorucu B Salman O Erdem M Sare E Tatlicioglu (2004) ArticleTitleUnexpected gallbladder cancer during laparoscopic cholecystectomy J Hepatobiliary Pancreat Surg 11 357–61 Occurrence Handle15549438 Occurrence Handle10.1007/s00534-004-0910-y

    PubMed  Article  Google Scholar 

  26. AP Mauderli CJ Vierck SuffixJr RL Cannon A Rodrigues C Shen (2003) ArticleTitleRelationships between skin temperature and temporal summation of heat and cold pain J Neurophysiol 90 100–9 Occurrence Handle12843304 Occurrence Handle10.1152/jn.01066.2002

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

  1. Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama, 641-8510, Japan

    Kazuhisa Uchiyama, Masaji Tani, Manabu Kawai, Hiroshi Terasawa, Takashi Hama & Hiroki Yamaue

Authors
  1. Kazuhisa Uchiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Masaji Tani
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Manabu Kawai
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroshi Terasawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takashi Hama
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hiroki Yamaue
    View author publications

    You can also search for this author in PubMed Google Scholar

About this article

Cite this article

Uchiyama, K., Tani, M., Kawai, M. et al. Clinical significance of drainage tube insertion in laparoscopic cholecystectomy: a prospective randomized controlled trial. J Hepatobiliary Pancreat Surg 14, 551–556 (2007). https://doi.org/10.1007/s00534-007-1221-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00534-007-1221-x

Keywords

  • Postoperative Pain
  • Laparoscopic Cholecystectomy
  • Drainage Tube
  • Visual Analogue Pain Scale
  • Visual Analogue Pain Scale Score