Volume 5, Issue 3-1, May 2017, Page: 28-32
Laparoscopy in Acute Cholecystitis: To Drain or Not to Drain
Aly Saber, Department of Surgery, Port-Fouad General Hospital, Port-Said, Egypt
Emad Hokkam, Department of Surgery, Faculty of Medicine, Jazan University, Jazan, KSA; Department of Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
Abdulmonem Alshayeb, Department of Surgery, Najran General Hospital, Najran, KSA
Received: Jan. 25, 2017;       Accepted: Jan. 29, 2017;       Published: Feb. 18, 2017
DOI: 10.11648/j.js.s.2017050301.16      View  2857      Downloads  94
Abstract
Introduction: Regarding cholecystectomy for acute cholecystitis, there is still debate regarding drain insertion. The aim of the present study was to detect if there is a beneficial added value to drain the abdomen in case of laparoscopic cholecystectomy for acute cholecystitis. Patients and Methods: A total of 120 patients diagnosed having acute cholecystitis were enrolled to this study and were divided according to the drain insertion into two main groups; with drain (group A) and without drain (group B). End Points: The primary endpoint was the presence of operative field fluid collection at abdominal ultrasonography when performed twenty four hours after surgery. Secondary endpoints included postoperative abdominal, length of hospital stay and wound infection. Results: Concerning the demographic data, there was no statistical significant difference between the two groups regarding age, sex and body mass index. The mean operative time, hospital stay, postoperative pain and wound infection rate were higher in drain versus no drain group. Conclusion: The present study showed that there was no added benefit for prophylactic drain insertion after cholecystectomy for acute calculous cholecystitis. Drain insertion may be a cause of delayed discharge and prolonged hospital stay after laparoscopic procedures. Increased intensity of postoperative pain and wound infection are claimed to be due to drain insertion.
Keywords
Acute Cholecystitis, Laparoscopy, Drain, No Drain
To cite this article
Aly Saber, Emad Hokkam, Abdulmonem Alshayeb, Laparoscopy in Acute Cholecystitis: To Drain or Not to Drain, Journal of Surgery. Special Issue: Minimally Invasive and Minimally Access Surgery. Vol. 5, No. 3-1, 2017, pp. 28-32. doi: 10.11648/j.js.s.2017050301.16
Copyright
Copyright © 2017 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Fahad S. Al Amri, Hala F. Ali, Abdul Rahman Nimeri, Abdul Rahman M. Al Amri, Adel A. Assiri, Mohammed I. Abdul Aziz. Mohammed A. Bawahab, Walid M Abd El Maksoud, Saeed A. Alsareii. Drainage vs. non-drainage after cholecystectomy for acute cholecystitis: a retrospective study. J Biomed Res. 2014 May; 28 (3): 240–245.
[2]
Shamim M. Routine Sub-hepatic Drainage versus No Drainage after Laparoscopic Cholecystectomy: Open, Randomized, Clinical Trial. Indian J Surg. Indian J Surg. 2013 Feb; 75 (1): 22–27.
[3]
El-Labban G, Hokkam E, El-Labban M, Saber A, Heissam K, El-Kammash S. Laparoscopic elective cholecystectomy with and without drain: A controlled randomised trial. J Minim Access Surg. 2012 Jul; 8 (3): 90-2.
[4]
Gurusamy KS, Samraj K. Routine abdominal drainage for uncomplicated open cholecystectomy. Cochrane Database Syst Rev 2007, 2, Art. No.: CD006003. DOI: 10.1002/14651858.CD006003.pub2.
[5]
Gurusamy KS, Samraj K, Mullerat P, Davidson BR. Routine abdominal drainage for uncomplicated laparoscopic cholecystectomy. Cochrane Database Syst Rev 2007, 4, Art. No.: CD006004. DOI: 10.1002/14651858.CD006004.pub3.
[6]
Saber A and Hokkam EN. Operative Outcome and Patient Satisfaction in Early and Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis. Minimally Invasive Surgery. 2014 (2014); 162643: 1-4.
[7]
Yamashita Y, Takada T, Strasberg SM, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Gomi H, Dervenis C, Windsor JA, Kim SW, de Santibanes E, Padbury R, Chen XP, Chan AC, Fan ST, Jagannath P, Mayumi T, Yoshida M, Miura F, Tsuyuguchi T, Itoi T, Supe AN; Tokyo Guideline Revision Committee. TG13 surgical management of acute cholecystitis. J Hepatobiliary Pancreat Sci. 2013; 20 (1): 89-96.
[8]
Bawahab MA, Abd El Maksoud WM, Alsareii SA, Al Amri FS, Ali HF, Nimeri A, Al Amri AM, Assiri AA, Abdul Aziz MI. Drainage vs. non-drainage after cholecystectomy for acute cholecystitis: a retrospective study. J Biomed Res. 2014 May; 28 (3): 240–245.
[9]
Moshe Schein. To Drain or not to Drain? The Role of Drainage in the Contaminated and Infected Abdomen: An International and Personal Perspective. World J Surg. 2008; 32: 312–21.
[10]
Henrik P, Nicolas D, Valentin, Pierre-Alain C. Evidence-based Value of Prophylactic Drainage in Gastrointestinal Surgery. Ann Surg. 2004; 240: 1074–85.
[11]
Karliczek A, Jesus EC, Matos D, Castro AA, Atallah AN, Wiggers T. Drainage or nondrainage in elective colorectal anastomosis: a systematic review and meta-analysis. Colorectal Dis. 2006; 8: 259–65.
[12]
Piero Lucarelli, Marcello Picchio, Jacopo Martellucci, Francesco De Angelis, Annalisa di Filippo, Francesco Stipa, Erasmo Spaziani. Drain After Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis. A Pilot Randomized Study. Indian J Surg. 2015; 77 (Suppl 2): 288–292.
[13]
Eidy M, Jesmi F, Raygan F, Pishgahroudsari M, Pazouki A. Evaluating the Effect of Drain Site on Abdominal Pain after Laparoscopic Gastric BypassSurgery for Morbid Obesity: A Randomized Controlled Trial. Bariatr Surg Pract Patient Care. 2015 1; 10 (1): 38–41.
[14]
Marcello Picchio, Pierino Lucarelli, Annalisa Di Filippo, Francesco De Angelis, Francesco Stipa, Erasmo Spaziani. Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy. JSLS. 2014 Oct-Dec; 18 (4): e2014.00242.
[15]
Uchiyama K, Tani M, Kawai M, Terasawa H, Hama T, Yamaue H. Clinical significance of drainage tube insertion in laparoscopic cholecystectomy: a prospective randomized controlled trial. J Hepatobiliary Pancreat Surg. 2007; 14: 551–556.
[16]
Tzovaras G., Liakou P., Fafoulakis F, et al. Is there a role for drain use in elective laparoscopic cholecystectomy? A controlled randomized trial. Am J Surg 2009; 197: 759–763.
[17]
Dallal RM., Bailey L., Nahmias N. Back to basics-clinical diagnosis in bariatric surgery. Routine drains and upper GI series are unnecessary. Surg Endosc 2007; 21: 2268–2271.
[18]
Takada T, Kawarada Y, Nimura Y, YoshidaM, Mayumi T, Sekimoto M, Miura F, Wada K, HirotaM, Yamashita Y, NaginoM, Tsuyuguchi T, Tanaka A, Kimura Y, Yasuda H, Hirata K, Pitt HA, Strasberg SM, Gadacz TR, Bornman PC, Gouma DJ, Belli G, Liau KH. Tokyo guidelines for the management of acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Surg, 2007, 14: 1–10.
[19]
Dougherty SH, Simmons RL. The biology and practice of surgical drains. Part II. Curr Probl Surg, 1992, 29: 633–730.
[20]
Gurusamy KS, Samraj K, Mullerat P, Davidson BR. Routine abdominal drainage for uncomplicated laparoscopic cholecystectomy (review). Cochrane Database Syst Rev (2007) 4: CD006004.
[21]
Tzovaras G, Liakou P, Fafoulakis F, Baloyiannis I, Zacharoulis D, Hatzitheofilou C. Is there a role for drain use in elective laparoscopic cholecystectomy? A controlled randomized trial. Am J Surg (2009) 197: 759–763.
[22]
Abbott J, Hawe J, Srivastava P, Hunter D, Garry R. Intraperitoneal gas drain to reduce pain after laparoscopy: randomized masked trial. Obstet Gynecol. 2001; 98: 97–100.
[23]
Liu CL, Fan ST, Lo CM, et al. Abdominal drainage after hepatic resection is contraindicated in patients with chronic liver diseases. Ann Surg. 2004; 239: 194–201.
[24]
Myers MB. Drain fever: a complication of drainage after cholecystectomy. Surgery. 1962; 52: 314–8.
[25]
Ahmet Gurer, Ersin Gurkan Dumlu, Erol Dikili, Gulten Kiyak, and Nuraydin Ozlem2. Is a Drain Required after Laparoscopic Cholecystectomy?. Eurasian J Med. 2013 Oct; 45 (3): 181–184.
[26]
Ammori BJ, Davides D, Vezakis A, Martin IG, Larvin M, Smith S, et al. Day-case laparoscopic cholecystectomy: a prospective evaluation of a 6-year experience. J Hepatobiliary Pancreat Surg. 2003; 10: 303–8.
[27]
Yeh CY, Changchien CR, Wang JY, Chen JS, Chen HH, Chiang JM, et al. Pelvic drainage and other risk factors for leakageafter elective anterior resection in rectal cancer patients: a prospective study of 978 patients. Ann Surg. 2005; 241: 9–13.
[28]
Petrowsky H, Demartines N, Rousson V, et al; Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg. 2004 Dec; 240 (6): 1074-84; discussion 1084-5.
[29]
Rather SA, Bari SU, Malik AA, et al; Drainage vs no drainage in secondary peritonitis with sepsis following complicated appendicitis in adults in the modern era of antibiotics. World J Gastrointest Surg. 2013 Nov 27; 5 (11): 300-5.
[30]
Borzellino G, Sauerland S, Minicozzi AM, Verlato G, Di Pietrantonj C, deManzoni G, Cordiano C (2008) Laparoscopic cholecystectomy for severe acute cholecystitis. A meta-analysis of results. Surg Endosc 22: 8–15.
Browse journals by subject