We found no significant differences between different types of drains .
Drains increase the harms to the patient without providing any additional benefit for patients undergoing open cholecystectomy and should be avoided in open cholecystectomy
BACKGROUND Cholecystectomy is the removal of gallbladder and is performed mainly for symptomatic gallstones .
Although laparoscopic cholecystectomy is currently preferred over open cholecystectomy for elective cholecystectomy , reports of r and omised clinical trials comparing the choice of cholecystectomy ( open or laparoscopic ) in acute cholecystitis are still being conducted .
Drainage in open cholecystectomy is a matter of considerable debate .
Surgeons use drains primarily to prevent subhepatic abscess or bile peritonitis from an undrained bile leak .
Critics of drain condemn drain use as it increases wound and chest infection .
OBJECTIVES To assess the benefits and harms of routine abdominal drainage in uncomplicated open cholecystectomy .
Randomized trial of drainage after cholecystectomy. Suction vaersus static drainage through a main wound versus a stab incision.
One hundred eighty-four patients who underwent biliary surgery were r and omly allocated to four groups arranaed in a 2 by 2 design . In 92 patients the drain was brought out through the wound and in the other 92 through a stab incision . In half of the patients in each group the drain was connected to a suction system and in the other half to a sterile bag . Suction was found to impair rather than enhance intraperitoneal drainage . In patients who underwent elective cholecystectomy and early operation for acute cholecystitis , the amount of discharge was more than twice as large when suction was omitted than when it was applied . After common duct operations the amount of discharge was very large and there was little difference in cases with and without suction . Prolonged drainage , static or suction , result ed in an increase in the serum haptoglobin level . Analysis of out data suggested that after a few days the drain starts to act as a traumatic stimulus . No difference was found between cases with the drain brought out through a stab incision and those with the drain brought out through the main wound . A number of studies have ascertained the superiority of closed to open drainage . The results of the present trial lead us to recommend that after biliary surgery the closed us to recommend that after biliary surgery the closed drain should not be connected to a suction apparatus and that after elective cholecystectomy the drain should preferably be removed after a few days
We found no significant differences between different types of drains .
Drains increase the harms to the patient without providing any additional benefit for patients undergoing open cholecystectomy and should be avoided in open cholecystectomy
BACKGROUND Cholecystectomy is the removal of gallbladder and is performed mainly for symptomatic gallstones .
Although laparoscopic cholecystectomy is currently preferred over open cholecystectomy for elective cholecystectomy , reports of r and omised clinical trials comparing the choice of cholecystectomy ( open or laparoscopic ) in acute cholecystitis are still being conducted .
Drainage in open cholecystectomy is a matter of considerable debate .
Surgeons use drains primarily to prevent subhepatic abscess or bile peritonitis from an undrained bile leak .
Critics of drain condemn drain use as it increases wound and chest infection .
OBJECTIVES To assess the benefits and harms of routine abdominal drainage in uncomplicated open cholecystectomy .