title: Drainage vs. non-drainage after cholecystectomy for acute cholecystitis: a retrospective study.
abstract: Many surgeons practice prophylactic drainage after cholecystectomy without reliable evidence. This study was conducted to answer the question whether to drain or not to drain after cholecystectomy for acute calculous cholecystitis. A retrospective review of all patients who had cholecystectomy for acute cholecystitis in Aseer Central Hospital, Abha, Saudi Arabia, was conducted from April 2010 to April 2012. Data were extracted from hospital case files. Preoperative data included clinical presentation, routine investigations and liver function tests. Operative data included excessive adhesions, bleeding, bile leak, and drain insertion. Complicated cases such as pericholecystic collections, mucocele and empyema were also reported. Patients who needed therapeutic drainage were excluded. Postoperative data included hospital stay, volume of drained fluid, time of drain removal, and drain site problems. The study included 103 patients allocated into two groups; group A (n  =  38) for patients with operative drain insertion and group B (n  =  65) for patients without drain insertion. The number of patients with preoperative diagnosis of acute non-complicated cholecystitis was significantly greater in group B (80%) than group A (36.8%) (P < 0.001). Operative time was significantly longer in group A. All patients who were converted from laparoscopic to open cholecystectomy were in group A. Multivariate analysis revealed that hospital stay was significantly (P < 0.001) longer in patients with preoperative complications. There was no added benefit for prophylactic drain insertion after cholecystectomy for acute calculous cholecystitis in non-complicated or in complicated cases.
authors.affiliation: General Surgery Department, Faculty of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Bawahab
authors.affiliation: General Surgery Department, Faculty of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
authors.forename: Walid M
authors.initials: WM
authors.lastname: Abd El Maksoud
authors.affiliation: General Surgery Department, Faculty of Medicine, Najran University, Najran, P.O. 1988, Saudi Arabia;
authors.forename: Saeed A
authors.initials: SA
authors.lastname: Alsareii
authors.affiliation: General Surgery Department, Faculty of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
authors.forename: Fahad S
authors.initials: FS
authors.lastname: Al Amri
authors.affiliation: General Surgery Department, Faculty of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
authors.forename: Hala F
authors.initials: HF
authors.lastname: Ali
authors.affiliation: General Surgery Department, Sheikh Khalifa Medical City, Abu Dhabi, P.O. 51900, United Arab Emirates;
authors.forename: Abdul Rahman
authors.initials: AR
authors.lastname: Nimeri
authors.affiliation: General Surgery Department, Faculty of Medicine, Najran University, Najran, P.O. 1988, Saudi Arabia;
authors.forename: Abdul Rahman M
authors.initials: AR
authors.lastname: Al Amri
authors.affiliation: General Surgery Department, Faculty of Medicine, Najran University, Najran, P.O. 1988, Saudi Arabia;
authors.forename: Adel A
authors.initials: AA
authors.lastname: Assiri
authors.affiliation: General Surgery, Abha Private Hospital, Abha 61431, Saudi Arabia.
authors.forename: Mohammed I
authors.initials: MI
authors.lastname: Abdul Aziz
keywords: acute cholecystitis; cholecystectomy; routine drainage; subhepatic collection