title: Drain After Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis. A Pilot Randomized Study.
abstract: Drainage after laparoscopic cholecystectomy (LC) for acute calculous cholecystitis (ACC) is used without evidence of its efficacy. The present pilot study was designed to address this issue. After laparoscopic gallbladder removal, 15 patients were randomized to have a drain positioned in the subhepatic space (group A) and 15 patients to have a sham drain (group B). The primary outcome measure was the presence of subhepatic fluid collection at abdominal ultrasonography, performed 24 h after surgery. Secondary outcome measures included postoperative abdominal and shoulder tip pain, use of analgesics, and morbidity. Abdominal ultrasonography did not show any subhepatic fluid collection in eight patients (53.3 %) in group A and in five patients (33.3 %) in group B (P = 0.462). If present, median (range) subhepatic collection was 50 mL (20-100 mL) in group A and 80 mL (30-120 mL) in group B (P = 0.573). No significant differences in the severity of abdominal and shoulder pain and use of parenteral ketorolac were found in either group. Two biliary leaks and one subhepatic fluid collection occurred postoperatively. The present study was unable to prove that the drain was useful in LC for ACC, performed in a selected group of patients.
authors.affiliation: Department of Surgery, Hospital "Madonna delle Grazie", Via Salvo D'Acquisto 77, 00049 Velletri, Rome Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Lucarelli
authors.affiliation: Department of Surgery, Hospital "P. Colombo", Via Orti Ginnetti 7, 00049 Velletri, Rome Italy ; Via Giulio Cesare, 58, 04100 Latina, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Picchio
authors.affiliation: Department of Surgery, University of Siena, Ospedale "Le Scotte", Viale Bracci 1, 53100 Siena, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Martellucci
authors.affiliation: Department of Surgery, University of Rome "La Sapienza", Polo Pontino, Via Firenze, 04019 Terracina, Latina Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Angelis
authors.affiliation: Department of Surgery, University of Rome "La Sapienza", Polo Pontino, Via Firenze, 04019 Terracina, Latina Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: di Filippo
authors.affiliation: Department of Surgery, Hospital "S. Giovanni-Addolorata", via dell'Amba Aradam 9, 00184 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Stipa
authors.affiliation: Department of Surgery, University of Rome "La Sapienza", Polo Pontino, Via Firenze, 04019 Terracina, Latina Italy.
authors.forename: Erasmo
authors.initials: E
authors.lastname: Spaziani
keywords: Cholecystectomy; Cholecystitis; Drainage; Laparoscopy; Postoperative complications