title: Meta-analysis of drainage versus no drainage after laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Routine drainage after laparoscopic cholecystectomy is still controversial. This meta-analysis was performed to assess the role of drains in reducing complications in laparoscopic cholecystectomy.
  
  
  METHODS
  An electronic search of Medline, Science Citation Index Expanded, Scopus, and the Cochrane Library database from January 1990 to June 2013 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in laparoscopic cholecystectomy. The odds ratio for qualitative variables and standardized mean difference for continuous variables were calculated.
  
  
  RESULTS
  Twelve randomized controlled trials were included in the meta-analysis, involving 1939 patients randomized to a drain (960) versus no drain (979). The morbidity rate was lower in the no drain group (odds ratio, 1.97; 95% confidence interval, 1.26 to 3.10; P = .003). The wound infection rate was lower in the no drain group (odds ratio, 2.35; 95% confidence interval, 1.22 to 4.51; P = .01). Abdominal pain 24 hours after surgery was less severe in the no drain group (standardized mean difference, 2.30; 95% confidence interval, 1.27 to 3.34; P < .0001). No significant difference was present with respect to the presence and quantity of subhepatic fluid collection, shoulder tip pain, parenteral ketorolac consumption, nausea, vomiting, and hospital stay.
  
  
  CONCLUSIONS
  This study was unable to prove that drains were useful in reducing complications in laparoscopic cholecystectomy.
authors.affiliation: Department of Surgery, Hospital "P. Colombo," Velletri, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Picchio
authors.affiliation: Basildon Hospital, Basildon, England.
authors.forename: Pierino
authors.initials: P
authors.lastname: Lucarelli
authors.affiliation: Department of Surgery, University of Rome "La Sapienza," Terracina, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Di Filippo
authors.affiliation: Department of Surgery, University of Rome "La Sapienza," Terracina, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Angelis
authors.affiliation: Department of Surgery, Hospital "S. Giovanni-Addolorata," Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Stipa
authors.affiliation: Department of Surgery, University of Rome "La Sapienza," Terracina, Italy.
authors.forename: Erasmo
authors.initials: E
authors.lastname: Spaziani
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004322:Drainage / Q000379:methods*; D006801:Humans; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*
keywords: Cholecystectomy; Drainage; Laparoscopy