DRAINS: DO WE NEED THEM ROUTINELY AFTER LAPAROSCOPIC CHOLECYSTECTOMY?

ABSTRACT
Objective: The aim of this study was to assess the effect of routine drainage after laparoscopic cholecystectomy on
post operative recovery.
Methods: From Dec 2010 to Dec 2012 patients undergoing elective cholecystectomy in Hayatabad Medical Complex
were randomized into 2 groups; Group A constituting patients who did not have any drainage procedure and Group B
with institution of a size 20 sub hepatic drain. Both groups were analyzed and compared for post operative abdominal
and shoulder tip pain recorded on a visual analogue score (0-10), sub hepatic collection detected by abdominal ultrasonography
24 to 36 hours after the procedure, complications such as wound infection and length of hospital stay.
Results: A total of 156 patients uniformly balanced in terms of their co-morbid status and gender, were equally divided
into two groups. Twenty four hours after surgery, patients in group B had a median abdominal pain score of 4 (2–7)
as compared to 3 (2–6) in group A (p=0.04). Abdominal scan revealed a significant (50ml) sub-hepatic collection in 3
patients in Gp A and 4 in group B while only one patient (GpA) had a drainage of more than 100ml. Mean hospital stay
was 1 day (1-6) in Gp A, as against a mean stay of 2 days (range 1-7) in Gp B (p=0.03)
Conclusion: Drains offer no benefit in terms of post operative recovery in patients undergoing laparoscopic cholecystectomy
with this study demonstrating an increase in the severity of post operative abdominal pain and length of
hospital stay in patients with this adjunct.
Key Words: Laparoscopic cholecystectomy, drain, abdominal pain, shoulder tip pain.