title: [Is there any indication for inserting a drain in elective laparoscopic cholecystectomy?].
abstract: BACKGROUND
  Classically, a sub-hepatic drain was inserted routinely in a cholecystectomy to prevent intra-abdominal abscesses, possible post-surgical bleeding, and biliary fistulas. Over the years, it has been demonstrated that the systematic use of a drain does not have any benefits, and many studies conclude that, in special circumstances (bleeding, signs of gallbladder inflammation, incidental opening, or suspected bile leak), and depending on the experience of the individual surgeon, the insertion of a drain may be of use.
  
  
  METHODS
  [corrected] A prospective study was conducted on 100 elective laparoscopic cholecystectomies performed due to symptomatic cholelithiasis or gallbladder polyps. A sub-hepatic drain was inserted in 15 of them. The indications for inserting it were: in 11 patients as a "control" due to a gallbladder bed bleed controlled during surgery, and in 4 due to a gallbladder opening with the excretion of turbid-purulent bile. The main outcomes investigated were the clinical benefit achieved by the insertion of the drain, the hospital stay, and the quantifying of the pain by the patients 24h after surgery, using a visual analogue scale.
  
  
  RESULTS
  The insertion of a drain was of no benefit to any patient. The median hospital stay increased by 1 day in patients with a drain (P=.002). The median pain score at 24h was higher in patients with a drain inserted (P=.018).
  
  
  CONCLUSIONS
  The insertion of a sub-hepatic drain after elective laparoscopic cholecystectomy increases post-surgical pain and prolongs hospital stay, and does not prevent the occurrence of intra-abdominal abscesses.
authors.affiliation: Servicio de Cirugía General, Hospital General Universitario de Elche, Alicante, España. jruiztovar@gmail.com
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.forename: Irene
authors.initials: I
authors.lastname: Ortega
authors.forename: Jair
authors.initials: J
authors.lastname: Santos
authors.forename: Liliana
authors.initials: L
authors.lastname: Sosa
authors.forename: Laura
authors.initials: L
authors.lastname: Armañanzas
authors.forename: María
authors.initials: M
authors.lastname: Diez Tabernilla
authors.forename: Alicia
authors.initials: A
authors.lastname: Calero
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.forename: Israel
authors.initials: I
authors.lastname: Oliver
authors.forename: Salvador
authors.initials: S
authors.lastname: García
authors.forename: Rafael
authors.initials: R
authors.lastname: Calpena
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D004322:Drainage; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies