Publication:

Drain versus no drain in an uncomplicated elective laparoscopic cholecystectomy- an institutional study

Background Laparoscopic cholecystectomy (LC) is the gold standard for symptomatic gallstones. Post surgery to keep a subhepatic drain is an issue of debate. A randomised trial was designed to assess the outcome of drain in elective lap cholecystectomy.

Methods A randomized control trial was done from January 2019 to June 2020 among 40 patients. They were randomised into group A: (n=20) in which subhepatic space was drained by an abdominal drain size 28F drain which was brought out through right anterior axillary port (even group) and group B: (n=20) in which there was no-drain at sub hepatic space (odd group). The end points of this study was to compare postoperative pain, fever, wound infection ,hospital stay between the two groups.

Results Mean hospital stay among drain group was 3.95±1.35 days as compared to 2.55±0.60 days among no drain group and the difference was statistically significant (p value =0.001). 8 (40%) patients with drain had port side infection as compared to 1 (5%) patient among no drain group and the observed difference was statistically significant (p value =0.02). Post operative pain abdomen assessed using VAS, and found significant 12 after surgery. The young female patients were unhappy with the drain scar and 3 cases requested for need of plastic surgery corrections also.

Conclusions The routine use of a drain in uncomplicated elective laparoscopic cholecystectomy has no benefit; in contrast, it is associated with longer hospital stay, so better to avoid the drain.