title: The Value of Abdominal Drainage After Laparoscopic Cholecystectomy for Mild or Moderate Acute Calculous Cholecystitis: A Post Hoc Analysis of a Randomized Clinical Trial.
abstract: Although the preoperative management of mild and moderate (Grade I-II) acute calculous cholecystitis (ACC) has been standardized, there is no consensus on the value of abdominal drainage after early cholecystectomy.
  
  
  
  In a post hoc analysis of a randomized controlled trial (NCT01015417) focused on the value of postoperative antibiotic therapy in patients with ACC, we determined the value of abdominal drainage in patients having undergone laparoscopic cholecystectomy for Grades I-II ACC. All postoperative complications were analyzed after using a propensity score. A post hoc test was used to assess the statistical robustness of our results.
  
  
  
  Of the 414 enrolled patients, 178 did not have abdominal drainage (forming the no-drainage group) and 236 had drainage (the drainage group). After matching on PS, the deep incisional site infection was 1.1 versus 0.8 %, p = 0.78. This result is similar for the superficial incisional site infections; the distant infections; the overall morbidity, and the readmission rate. Only the hospital length of stay was significantly longer in the drainage group (3.3 vs. 5.1 days, p = 0.003). Neither abdominal drainage nor the absence of postoperative antibiotic therapy was found to be a risk factor for deep incisional site infections.
  
  
  
  The use of abdominal drainage depends on the surgeon's personal preferences but is often used in high-risk populations. However, abdominal drainage does not appear to be of any benefit (in terms of postoperative outcomes) and may even compromise recovery in patients having undergone early laparoscopic cholecystectomy for mild or moderate ACC.
authors.affiliation: Department of Digestive Surgery, Amiens University Medical Center, Amiens, France.|French National Surgical Research Network, Amiens, France.
authors.forename: Flavien
authors.initials: F
authors.lastname: Prevot
authors.affiliation: Department of Digestive Surgery, Amiens University Medical Center, Amiens, France.|French National Surgical Research Network, Amiens, France.
authors.forename: David
authors.initials: D
authors.lastname: Fuks
authors.affiliation: Department of Digestive Surgery, Amiens University Medical Center, Amiens, France.|INSERM U1088, Amiens, France.|Digestive Surgery Methodology Unit, Amiens University Medical Center, Amiens, France.|Clinical Research Center, Amiens University Medical Center, Amiens, France.|French National Surgical Research Network, Amiens, France.
authors.forename: Cyril
authors.initials: C
authors.lastname: Cosse
authors.affiliation: Department of Digestive Diseases, Lariboisière Hospital, Paris, France.|French National Surgical Research Network, Amiens, France.
authors.forename: Karine
authors.initials: K
authors.lastname: Pautrat
authors.affiliation: General and Digestive Surgery Department, Louis Mourier Hospital, Colombes, France.|French National Surgical Research Network, Amiens, France.
authors.forename: Simon
authors.initials: S
authors.lastname: Msika
authors.affiliation: Department of Digestive Surgery, Dupuytren Hospital, Limoges, France.|French National Surgical Research Network, Amiens, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Mathonnet
authors.affiliation: Department of Digestive Surgery, Rouen University Medical Center, Rouen, France.|French National Surgical Research Network, Amiens, France.
authors.forename: Haitham
authors.initials: H
authors.lastname: Khalil
authors.affiliation: Department of Digestive Surgery, Beauvais Hospital, Beauvais, France.|French National Surgical Research Network, Amiens, France.
authors.forename: François
authors.initials: F
authors.lastname: Mauvais
authors.affiliation: Department of Digestive Surgery, Amiens University Medical Center, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.|Clinical Research Center, Amiens University Medical Center, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.|French National Surgical Research Network, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.|EA4294, Jules Verne University of Picardie, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.|Department of Digestive and Oncological Surgery, New University Hospital Centre, Avenue René Laennec, Cedex 1, F-80054, Amiens, France. regimbeau.jean-marc@chu-amiens.fr.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D041881:Cholecystitis, Acute / Q000601:surgery*; D004322:Drainage; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D057216:Propensity Score; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000453:epidemiology; D055815:Young Adult