Page 7 - Journal of WALS

WJOLS

10.5005/jp-journals-10007-1151
Drainage in Cholecystectomy: Required or Not? A Comparative Randomized Study in Northern Indian Subjects
ORIGINAL RESEARCH
Drainage in Cholecystectomy: Required or Not?

A Comparative Randomized Study in

Northern Indian Subjects

Aman Nagpal, Subhash Goyal, Latika Abbey, Abhishek Singh

ABSTRACT laparoscopic cholecystectomy has revolutionized this
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Background: Routine abdominal drainage after laparoscopic procedure. The need to put a drain has always been a
cholecystectomy is an issue of considerable debate in surgical controversial subject in surgery. There are those who believe
fraternity. So a comparative study was planned as an effort to that all intraperitoneal operations should be drained and
solve the controversy regarding the need of drainage in
cholecystectomy. there are others who feel drains are useless. Number of
drains available bears witness to the fact that no one is ideal
Aim: The aim of the study was to evaluate merits and demerits
of drainage vs nondrainage in patients undergone or suitable for universal use.
cholecystectomy. Therapeutic drains are a necessity, prophylactic drains
Materials and methods: Study was carried out in the are in questions and perhaps this can be answered by age
Department of General Surgery, MM Institute of Medical old saying that drains cannot substitute a meticulous
Sciences and Research between June 2009 and October 2011 technique. Higher wound infection has been reported in
on 40 cases of symptomatic gall stone disease. Cases were drain group. Hospital stay is also prolonged as none of
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divided randomly into two equal groups. Group A containing
20 cases with drain placed and group B containing 20 cases patient can be discharged on same day. Some studies have
without drainage. Subjects were observed for postoperative demonstrated that infection rate and reoperation rate were
morbidity in the form of pain–incidence and severity, duration not significantly different irrespective of whether drains
of postoperative hospital stay, analgesia requirement,
postoperative nausea, vomiting and antiemetics required. were put or not. Also, some studies showed that post
laparoscopic cholecystectomy, pain was not statistically
Results: Mean operative time in groups A and B was 93 and
86 minutes respectively. Gallbladder rupture was most common different between drain and no drain group.
complication encountered in both the groups. At 12th So, in review of this unresolved controversy regarding
postoperative hour, 90% of patients of group A and 95% of necessity of using drains in cholecystectomy present study
patients of group B had pain in abdomen.
was planned with the aim to evaluate merits and demerits
Conclusion: We found no significant advantage of using of drainage vs nondrainage in the patients undergoing
drainage after laparoscopic cholecystectomy, as there was
higher incidence of postoperative pain and longer duration of cholecystectomy. Objectives of the study were to find out
hospital stay with its use. Therefore, its routine use cannot be incidence of postoperative morbidity in terms of
recommended as a means to reducing postoperative morbidity.
complications among patients undergoing cholecystectomy
Keywords: Cholecystectomy, Drainage, Postoperative care. with and without drain and to detect difference in operative
How to cite this article: Nagpal A, Goyal S, Abbey L, Singh A. time and hospital stay in the above groups.
Drainage in Cholecystectomy: Required or Not? A Comparative
Randomized Study in Northern Indian Subjects. World J Lap MATERIALS AND METHODS
Surg 2012;5(2):63-66.
The present study was carried out in the Department of
Source of support: Nil
General Surgery, Maharishi Markandeshwar Institute of
Conflict of interest: None declared
Medical Sciences and Research (MMIMSR), Mullana
(Ambala) between June 2009 and October 2011 in which
INTRODUCTION
40 cases of symptomatic gallstone disease were admitted
Cholelithiasis is among the most common gastrointestinal for cholecystectomy included in the study. These 40 cases
illness requiring hospitalization and frequently occurs in were randomized into two groups equally, group A contains
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young. Cholelithiasis and associated complications are the 20 cases with drain placed in subhepatic space and brought
leading causes of surgical entry into the peritoneal cavity out through right anterior axillary port and group B contains
in Northern India. Cholecystectomy remains the treatment 20 cases without drain.
of choice of symptomatic gall stones despite the challenges The inclusion criteria’s for study group were symptoms
of dissolution therapy and lithotripsy. The introduction of consistent with biliary colic, fit for general anesthesia and
World Journal of Laparoscopic Surgery, May-August 2012;5(2):63-66 63