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Drain After Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis. A Pilot Randomized Study
Authors:Piero Lucarelli  Marcello Picchio  Jacopo Martellucci  Francesco De Angelis  Annalisa di Filippo  Francesco Stipa  Erasmo Spaziani
Affiliation:1.Department of Surgery,Hospital “Madonna delle Grazie”,Velletri,Italy;2.Department of Surgery,Hospital “P. Colombo”,Velletri,Italy;3.Department of Surgery,University of Siena, Ospedale “Le Scotte”,Siena,Italy;4.Department of Surgery,University of Rome “La Sapienza”,Terracina,Italy;5.Department of Surgery,Hospital “S. Giovanni-Addolorata”,Rome,Italy;6.Latina,Italy
Abstract:Drainage after laparoscopic cholecystectomy (LC) for acute calculous cholecystitis (ACC) is used without evidence of its efficacy. The present pilot study was designed to address this issue. After laparoscopic gallbladder removal, 15 patients were randomized to have a drain positioned in the subhepatic space (group A) and 15 patients to have a sham drain (group B). The primary outcome measure was the presence of subhepatic fluid collection at abdominal ultrasonography, performed 24 h after surgery. Secondary outcome measures included postoperative abdominal and shoulder tip pain, use of analgesics, and morbidity. Abdominal ultrasonography did not show any subhepatic fluid collection in eight patients (53.3 %) in group A and in five patients (33.3 %) in group B (P?=?0.462). If present, median (range) subhepatic collection was 50 mL (20–100 mL) in group A and 80 mL (30–120 mL) in group B (P?=?0.573). No significant differences in the severity of abdominal and shoulder pain and use of parenteral ketorolac were found in either group. Two biliary leaks and one subhepatic fluid collection occurred postoperatively. The present study was unable to prove that the drain was useful in LC for ACC, performed in a selected group of patients.
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