Cholecystectomy with intraperitoneal drain. Presence and significance of conjugated bilirubin in the drainage fluid.
The content of conjugated bilirubin in the drainage fluid of 85 patients, operated upon consecutively with cholecystectomy and intraperitoneal drain for nonacute gallbladder pathology was measured by the adapted method of Jendrassik and Grof. The measured amounts varied from 0 to 755 micromol. A weak correlation was found between the concentration of conjugated bilirubin and the total amount of drainage fluid (r = 0.37). In the majority of patients the evacuated amounts of conjugated bilirubin corresponded to the content of bilirubin in a few milliliters of hepatic bile. In 10% of the patients there were however greater amounts of conjugated bilirubin in the drainage fluid. Greater amounts of conjugated bilirubin were significantly more often evacuated from patients operated upon by surgeons with less than 3 years of surgical experience compared to patients operated upon by more experienced surgeons. The amount of conjugated bilirubin in the drainage fluid was not significantly correlated with operative blood loss, dryness of the operative field at the end of the operation or iatrogenic perforation of the gallbladder during operation. Higher (however not significant) temperatures and bilirubin levels in serum were observed in patients with greater amounts of conjugated bilirubin in the drainage fluid. Increased amounts of conjugated bilirubin in the drainage fluid were not significantly associated with increased postoperative morbidity. Two of the patients with large amounts of conjugated bilirubin in the drainage fluid were reoperated because of bile leakage/abscess but the remaining patients had no serious complication, which could be a result of efficiency of the intraperitoneal drain.
D000328:Adult; D000368:Aged; D001646:Bile / Q000032:analysis*; D001663:Bilirubin / Q000032:analysis*; D002763:Cholecystectomy / Q000009:adverse effects; D002983:Clinical Competence; D004322:Drainage; D005260:Female; D005705:Gallbladder Diseases / Q000378:metabolism / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications
D001663:Bilirubin