Page 9 - Journal of WALS

WJOLS

Drainage in Cholecystectomy: Required or Not? A Comparative Randomized Study in Northern Indian Subjects

Table 2: Postoperative incidence and VAS score of pain abdomen in patients of two groups
Incidence of pain abdomen VAS score of pain abdomen
Time (hrs) Group A (%) Group B (%) p-value Group A Group B p-value
Mean Standard Mean Standard
deviation deviation
0 5 (25) 7 (35) 0.490 0.55 0.99 1.6 2.30 0.069
6 10 (50) 10 (50) 1.00 3.2 3.39 3.85 3.97 0.582
12 18 (90) 19 (95) 0.548 2.35 1.08 2.70 1.12 0.325
24 13 (65) 14 (70) 0.735 1.3 1.17 0.85 0.74 0.156
48 3 (15) 4 (20) 0.677 0.30 0.73 0.20 0.41 0.597

Table 3: Postoperative incidence of drain site pain (right anterior axillary port site)
Incidence of drain site pain VAS score of drain site pain
Time (hrs) Group A (%) Group B (%) p-value Group A Group B p-value
Mean Standard Mean Standard
deviation deviation
0 11 (55) 14 (70) 0.002 0.80 0.95 0.15 0.48 0.01
6 14 (70) 3 (15) 0.000 1.55 1.60 0.20 0.52 0.001
12 12 (60) 2 (10) 0.000 1.40 1.50 0.10 0.30 0.001
24 9 (45) 0 (0) 0.000 0.60 0.75 0.00 0.00 0.001
48 4 (20) 0 (0) 0.035 0.30 0.65 0.00 0.00 0.048

Table 4: Number of patients given analgesics at different point of time and patients required antiemetics
Patients given analgesics Patients required antiemetics
Time (hrs) Group A (%) Group B (%) p-value Group A (%) Group B (%) p-value
0 16 (80) 18 (90) 0.381 10 (50) 17 (85) 0.019
6 13 (65) 16 (80) 0.294 7 (35) 14 (70) 0.028
12 10 (50) 12 (60) 0.53 5 (25) 12 (60) 0.027
24 4 (20) 5 (25) 0.708 1 (5) 8 (40) 0.008
48 2 (10) 3 (15) 0.636 0 (0) 4 (20) 0.037

5,6
the overall stay. Others showed equal stay in both groups.
This difference is due to the fact that none of the patient in
the drain group could be discharged before removal of the
drain, thus increasing overall hospital stay and moreover
expenditure.

CONCLUSION

To conclude use of drains in laparoscopic cholecystectomy
has not much to offer; in the contrary it can be associated
with increased pain. We find no significant advantage of
using drain after laparoscopic cholecystectomy, therefore,
Graph 1: Mean pain score at different sites in study groups, its routine use cannot be recommended as a means to reduce
group A (gray bar) and group B (black bar) nausea/vomiting as there is higher incidence of postoperative
pain and longer duration of hospital stay with its use.
Comparison of Postoperative Stay in Hospital in However, in a select group of patients it can be justifiable
Both the Groups to leave a drain where there is a fear of unsolved or potential

Mean hospital stay was 5.75 and 3.65 days in groups A and bile leak, i.e. imperfect closure of cystic duct or bile staining
B respectively, i.e. higher in group A than in group B. in the lavage fluid or gallbladder bed suggesting the
Probably this was due to the reason that none of the patient possibility that an accessory duct has been missed.
could be discharged before removal of drain thus increasing Simultaneously while putting the drain one need to bear in
World Journal of Laparoscopic Surgery, May-August 2012;5(2):63-66 65