Subhepatic drain has no role after uncomplicated laparoscopic cholecystectomy: A prospective randomized double blind stu
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R A N D O M I Z E D CO N T R O L T R I A L
Subhepatic Drain Has No Role After Uncomplicated Laparoscopic Cholecystectomy: A Prospective Randomized Double Blind Study Marwah Sanjay, Pandey Siddharth, Jangra Mahavir S, Singh Hardeep, Singla Priyanka, Singh Jangvir
Abstract Aim-Background: Laparoscopic cholecystectomy is the gold standard treatment of symptomatic cholelithiasis. Since
the advent of laparoscopic cholecystectomy, there has been a dilemma regarding the role of drainage after surgery. Several studies in the past have compared drainage versus non-drainage in such cases. However, there has always been bias among the two groups during postoperative monitoring. The present study aimed to eliminate this bias and provide true randomization with the placement of sham drains in the control group cases. Materials and Methods: The authors in this prospective randomised double-blind study divided 100 patients un-
dergoing uncomplicated laparoscopic cholecystectomy into two groups of 50 each; one group underwent placement of subhepatic drains and the other placement of sham drains in the parieties. Results: Mean duration of surgery, postoperative vomiting, shoulder tip pain, analgesic requirement and hospital stay were comparable among the two groups (p>0.05). The postoperative abdominal pain score and subhepatic collection were significantly more in the subhepatic drain group (p0.05). Conclusion: The results of the study clearly indicated that subhepatic drainage provides no benefit after uncompli-
cated laparoscopic cholecystectomy and can thus be safely omitted in such cases. Key words: Cholecystectomy; laparoscopy; peritoneal drainage
Introduction Cholelithiasis is a common disease all over the world and gallstones can be found in 10 to 20% of the population at some stage of life [1]. Cholecystectomy is the second most common operation in gastrointestinal surgery after appendectomy. The first open cholecystectomy was performed by Langenebuch in 1882, with peritoneal drainage as part of the procedure. Ever since, the routine placement of drains has become a part of this operation. Traditionally, the drains were used for the early detection of bile leak and any unsuspected haemorrhage, and to evacuate abdominal fluid collections without the need for more invasive procedures [2]. However, controversy surrounded this practice in elective open cholecystectomy, with most surgeons departing from this approach [3,4]. Laparoscopic Marwah Sanjay, Pandey Siddharth, Jangra Mahavir S, Singh Hardeep, Singla Priyanka, Singh Jangvir Department of Surgery, Post graduate Institute of Medical Sciences, Rohtak, Haryana, India Corresponding author: Dr Sanjay Marwah 2452, Sector I, HUDA, Rohtak Haryana, India Tel.: +91 9416336886, e-mail: [email protected] Received 30 June 2015; Accepted 10 Sept 2015
Hellenic Journal of Surgery 87
cholecystectomy was introduced as an alternative to the conventional removal of the gallbladder [5]. However, it has become a gold standard procedure over time. With the increased use of the
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