Necessity of the routine abdominal drainage after laparoscopic cholecystectomy (LC).

L. Szpaszkij, T.Vanca, B. Berényi, I. Dudás*, A. Zsirka-Klein, P. Lukovich

1st Department of Surgery and Radiology*, Semmelweis University, Budapest, Hungary

British Journal of Surgery-ben megjelent absztrakt.

Introduction: The patients after transvaginal hybrid cholecystectomies (NOTES) - owing to the lesser pain - are discharged 4-6 hours after the operation. There is no facility to leave drain after this procedure.

Methods: Data of 100 patients having undergone LC beginning from 01.09.2009 were collected in a prospective study. The quality and the volume of the fluid emptied through the abdominal drain were analyzed. On the 1st. postoperative day the drain was removed and ultrasound was made to demonstrate residual liquid in the abdominal cavity. The pain of the patients was recorded by a numeric scale (1-10 points).

Results: The average fluid in the drain was 25 ml. The ultrasound could not see any liquid in 85% and less than 10 ml liquid in 15 % of the patient. The average pain was 5.5 on the day of the operation, which decreased to 4.0 on the 1st and was irrelevant on the 2nd day. 93% of the patients signalled that the drain caused pain while inside and during removal. One patient was reoperated because of bleeding, but only minimal blood was detected in the drain, in spite of the correct position of the drain which was detected by CT.

Conclusion: The drain and its removal is painful for the patients. Based on the data of our prospective study it is not necessary to leave a drain routinely after LC.