title: Is routine drain insertion after laparoscopic cholecystectomy for acute cholecystitis beneficial? A multicenter, prospective randomized controlled trial.
abstract: BACKGROUND
  There is a lack of evidence regarding the role of drainage in laparoscopic cholecystectomy (LC) for acutely inflamed gallbladder (AIGB), and drain insertion remains controversial.
  
  
  METHODS
  From December 2013 to November 2014, a total of 193 patients who needed LC due to AIGB at the four participating hospitals were entered in this study. After the operation, the patients were randomly assigned to undergo drain insertion (94 patients, 48.7%, group A) or not (99 patients, 51.3%, group B). The surgical outcomes between the two groups were prospectively reviewed. The study was registered at www.clinicaltrials.gov at the inception of enrollment (NCT02027402).
  
  
  RESULTS
  Both groups were comparable in terms of patient demographics, operative time and postoperative hospital stay. In 18 cases (9.3%), postoperative morbidities such as bleeding, bile leakage, wound infection or an abscess occurred, and there was no significant difference between the two groups. The visual analog scale pain score measured at 24 h (3.9 ± 1.4 in group A and 3.3 ± 2.0 in group B, P = 0.014) and 48 h (2.1 ± 1.5 in group A and 1.5 ± 1.4 in group B, P = 0.006) was significantly higher in group A.
  
  
  CONCLUSIONS
  Routine drain insertion does not prevent or reduce postoperative morbidities after LC for AIGB and can even cause prolonged postoperative pain. This prospective study suggests that routine drain use in LC for AIGB should be reconsidered.
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Korea.
authors.forename: Soo Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Korea.
authors.forename: Jun Suh
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Bupyeong, Korea.
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Yoon
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Bupyeong, Korea.
authors.forename: Sung Kyun
authors.initials: SK
authors.lastname: Park
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea.
authors.forename: Ho Joong
authors.initials: HJ
authors.lastname: Choi
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors.forename: Dong Do
authors.initials: DD
authors.lastname: Yoo
authors.affiliation: Department of Hepato-biliary and Pancreas Surgery, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-daero 222, Seocho-gu, Seoul, 137-701, Korea. gshth@catholic.ac.kr.
authors.forename: Tae Ho
authors.initials: TH
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Acute cholecystitis; Cholecystectomy; Drain; Laparoscopy; Morbidity