title: Cholecystectomy with and without drainage: a prospective randomised study.
abstract: The use of subhepatic intraperitoneal drains was prospectively studied in 100 patients who underwent elective cholecystectomy for symptomatic gallstones. These patients were randomised to have subhepatic drains (group A, n = 50 patients) or to have no drains (group B, n = 50 patients). There was no difference in the age or sex composition of the two groups. The patients were followed in the post-operative period (0-7 days) for evidence of fever, wound infection, septicaemia and any evidence of intra-peritoneal bile leakage. Also post operative hospital stay of patients was noted. In group A, 14 patients (28%) developed spikes of temperature of 38 degrees C or more while only 5 patients (10%) in group B developed such episodes. The difference was statistically significant between the two groups (P < 0.05). Wound infection occurred significantly more (P < 0.05) in group A (in 15 patients) as compared to group B (in 5 patients). Septicaemia occurred in 2 patients in group A and in none in group B. There was no evidence of intraperitoneal bile leakage in either group. Patients in group A tended to have longer post operative hospital stay (mean of 10.2 days) than patients in group B (mean 8.7 days); but the difference between the two groups in this respect was not significant. We conclude that subhepatic intra-peritoneal drains offered no additional advantage in elective cholecystectomy. The evidence we had pointed to their harmful effects.
authors.affiliation: Department of Surgery, Faculty of Medicine, University of Khartoum, Sudan.
authors.forename: A M
authors.initials: AM
authors.lastname: Saad
authors.forename: A M
authors.initials: AM
authors.lastname: el Hassan
mesh_terms: D001646:Bile; D002763:Cholecystectomy / Q000379:methods*; D002767:Cholecystostomy / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D011183:Postoperative Complications; D011446:Prospective Studies; D018805:Sepsis / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology