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

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