Document Type : Original Article
Authors
1
Lecturer of General Surgery, Faculty of Medicine, Zagazig University, Egypt
2
Professor of General Surgery, Faculty of Medicine, Zagazig University, Egypt
3
Department of General Surgery, Faculty of Medicine, Zagazig University, Egypt
Abstract
Background: The use of prophylactic drains after laparoscopic cholecystectomy (LC) remains controversial. Although drains have traditionally been employed to detect bleeding, bile leakage, or intra-abdominal collections, recent evidence questions their necessity and highlights potential disadvantages such as increased pain, infection, and delayed recovery. This study aimed to identify predictive factors associated with drain placement after LC and to evaluate their impact on postoperative outcomes. Methods: This retrospective cross-sectional study, which involved 405 patients who had a laparoscopic cholecystectomy. Patients were split into two groups; Group I (n = 88) had drains installed, whereas Group II (n=317) did not. Analysis was done on preoperative demographics, intraoperative factors, and postoperative results. Results: The distribution of sexes did not significantly change between the groups, however patients in the drain group were considerably older (p=0.03) and had a higher BMI (p=0.03). Acute cholecystitis, longer operative time, technical difficulties, blood loss >10ml, and procedures performed by experienced surgeons were significantly associated with drain placement (p<0.001). Patients with drains had significantly longer operative duration (106vs. 58 minutes), prolonged hospital stay (3.5vs. 1.3days), higher postoperative pain scores, and increased rates of intra-abdominal fluid collections, port-site hernia, and bile contamination compared to the non-drain group. Conclusion: Drain placement after LC is not influenced by demographics but is strongly associated with intraoperative complexity. Drains were linked to worse postoperative outcomes, including longer hospitalization, higher pain, and greater morbidity. Routine use of drains is not recommended and should be reserved only for selected high-risk cases.
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