title: To drain or not to drain elective uncomplicated laparoscopic cholecystectomy? A systematic review and meta-analysis.
abstract: Laparoscopic cholecystectomy (LC) has largely replaced conventional cholecystectomy in the past decade. However, there are still limited data about the value of prophylactic sub-hepatic drainage for elective uncomplicated LC. We carried out a systematic review of the literature in order to perform a meta-analysis about this issue. An unrestricted search in MEDLINE, EMBASE and Cochrane Library up to 31 December 2013 was performed. Overall, seven high-methodological quality randomized controlled trials (RCTs) were included in the meta-analysis, resulting in 1310 patients totally. The incidence of abdominal collections, wound infection and overall mortality according to the presence or absence of the sub-hepatic drainage were meta-analyzed. Sub-hepatic drainage showed an increase in the abdominal collection rate in patients who underwent elective uncomplicated LC (OR 1.56, 95% CI 1.00-2.43) if compared to patients without drainage. A non-significant correlation was found in overall mortality and infection rates. The meta-analysis shows that the presence of the sub-hepatic drainage does not reduce the incidence of abdominal collection after uncomplicated LC, whereas it does not influence wound infection and mortality rates, postoperative pain and hospital stay.
authors.affiliation: General Surgery, "San Giovanni Battista" Hospital, USL Umbria 2, Via M. Arcamone, 06034, Foligno (Perugia), Italy. walterbugiantella@alice.it.
authors.forename: Walter
authors.initials: W
authors.lastname: Bugiantella
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Vedovati
authors.forename: Cecilia
authors.initials: C
authors.lastname: Becattini
authors.forename: Ruben Carlo Balzarotti
authors.initials: RC
authors.lastname: Canger
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
authors.forename: Fabio
authors.initials: F
authors.lastname: Rondelli
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D041761:Cholecystolithiasis / Q000601:surgery*; D003657:Decision Making; D004322:Drainage; D017558:Elective Surgical Procedures / Q000379:methods*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*
keywords: Cholecystectomy; Drain; Laparoscopic; Meta-analysis