Laparoscopic Cholecystectomy with and without use of Drain in Selected Cases

Gall stones and Cholecystitis are very common pathologies in surgical practice, laparoscopic cholecystectomy nowadays is the preferred procedure to remove the gall bladder since established in 1987. This is prospective study done in Al- Imamain-Al-kadhimain medical city/Al-Kadhimiya teaching hospital / department of general surgery where more than 400 laparoscopic Cholecystectomy are done per year. Objective: to evaluate the real need of draining the site of uncomplicated laparoscopic Cholecystectomy (lap.chole.). Methodology: this is a comparative prospective study done in department of general surgery /Al –Kadhimiya teaching hospital between January 2010 and December 2011, at this time 400 cases of lap. chole. were Done by a team of four surgeons for patients with gall stones 72 males and 328 females. All these cases were uncomplicated gall stones and the rate of conversion to open surgery was zero. The patients were followed (after divided into 2 groups: group A without drain consist of 150 patients and group B with drain consist of 250 patients) for mortality, morbidity, infection, post operative pain and intra peritoneal collection. Results: Male to female ratio was approximately 1:4 . Age ranging between 22 and 73 years (mean: 47.5 year). Hospital stay was 3-4 days including operative day in group B patients while it was 2-3 days including operative day in group A patients. There was increasing post operative pain and drain site infection in group B .there was no mortality in both groups of patients. Conclusions: there is no need to put a drain at the site of laparoscopic Cholecystectomy routinely unless there is anticipated complication or need to monitor the operative site as it increases post operative pain, wound infection and hospital stay.