Comparative study of laparoscopic cholecystectomy with and without drains

Authors

  • Dharamdev D. Department of General Surgery, Kanachur Institute of Medical Sciences, Natekal, Manglore, Karnataka, India
  • Rupa Merlyn Mascarenhas Department of General Surgery, A. J. Institute of Medical Sciences, Kuntikana, Manglore, Karnataka, India
  • Anand Bhandary Department of General Surgery, A. J. Institute of Medical Sciences, Kuntikana, Manglore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20213588

Keywords:

Laparoscopic cholecystectomy, Subhepatic drain

Abstract

Background: Gallstones and cholecystitis are very common pathologies in surgical practice. Laparoscopic cholecystectomy (LC) is the preferred procedure to remove the gallbladder (GB) worldwide. The main objective of this study was to evaluate the merits and demerits of placing drain after LC and to find out the clinico-pathologic conditions in which the placement of drain was justifiable.

Methods: 100 patients who underwent LC were divided into 2 groups, group A (patients with drain) and group B (patients without drain). Interventional type, single-blind study was done. Complete history, evaluation and relevant data of both groups were done and analysed using descriptive statistics and Chi square test.

Results: In group A, 44% were males and 56% females whereas in group B, 42% were males and 58% were females. There was a statistically significant difference (p value<0.05) between 2 groups in Visual analog scale (VAS) grading. Wound infection was seen in 14% in group A and 02% in group B; mean hospital stay in group A was 8.38±1.86 days and in group B was 4.68±1.25 days. Nausea and vomiting were noted in 46% among group A and 04 % among group B.

Conclusions: Placement of drain after LC has nothing to offer, in contrast, it was associated with more pain. It would be reasonable to leave a drain if there was worry about an unsolved or potential bile leak only.

Author Biographies

Dharamdev D., Department of General Surgery, Kanachur Institute of Medical Sciences, Natekal, Manglore, Karnataka, India

Department of surgery, Associate professor

Rupa Merlyn Mascarenhas, Department of General Surgery, A. J. Institute of Medical Sciences, Kuntikana, Manglore, Karnataka, India

Department of General Surgery, Assistant Professor

Anand Bhandary, Department of General Surgery, A. J. Institute of Medical Sciences, Kuntikana, Manglore, Karnataka, India

Department of General Surgery, Former Resident

References

Yoo EH, Lee SY. The prevalence and risk factors for gallstone disease. Clin Chem Lab Med. 2009;47(7):795-807.

Blum CA, Adams DB. Who did the first laparoscopic cholecystectomy?. J Minim Access Surg. 2011;7(3):165-8.

Kitano S, Matsumoto T, Aramaki M, Kawano K. Laparoscopic cholecystectomy for acute cholecystitis. J Hepatobiliary Pancreat Surg. 2002;9(5):534-7.

Tzovaras G, Liakou P, Fafoulakis F, Baloyiannis I, Zacharoulis D, Hatzitheofilou C. Is there a role for drain use in elective laparoscopic cholecystectomy? A controlled randomized trial. Am J Surg. 2009;197(6):759-63.

Picchio M, Angelis F, Zazza S, Filippo A, Mancini R, Pattaro G, et al. Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial. Surg Endosc. 2012;26(10):2817-22.

Picchio M, Lucarelli P, Filippo A, Angelis F, Stipa F, Spaziani E. Meta-analysis of drainage versus no drainage after laparoscopic cholecystectomy. JSLS. 2014;18(4):2014.

Darbar R, Pipariya PR. To Study the Drain versus No Drain in Laparoscopic Cholecystectomy. JMSCR. 2019;7(5):1-5.

Koti RS, Davidson CJ, Davidson BR. Surgical management of acute cholecystitis. Langenbecks Arch Surg. 2015;400(4):403-19.

Shamim M. Routine Sub-hepatic Drainage versus No Drainage after Laparoscopic Cholecystectomy: Open, Randomized, Clinical Trial. Indian J Surg. 2013;75(1):22-7.

Halim A, Ahmad I, Iqbal J, Khan Z. Role of drain in laparoscopic cholecystectomy. J Med Sci. 2011;19: 49-53.

Hawasli A, Brown E. The effect of drains in laparoscopic cholecystectomy. J Laparoendosc Surg. 1994;4(6):393-8.

Satinsky I, Mittak M, Foltys A, Dostalik J. Subhepatic drainage in laparoscopic cholecystectomy-a necessity or an overused tradition?. RozhlChir. 2003;82:427-31.

Tzovaras G, Liakou P, Fafoulakis F, Baloyiannis I, Zacharoulis D, Hatzitheofilou C. Is there a role for drain use in elective laparoscopic cholecystectomy? A controlled randomized trial. Am J Surg. 2009;197(6):759-63.

Gurusamy KS, Samraj K, Mullerat P, Davidson BR. Routine abdominal drainage for uncomplicated laparoscopic cholecystectomy. Cochrane Database Syst Rev. 2007;(4):6004.

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Published

2021-08-27

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Original Research Articles