A randomized study of cholecystectomy with and without drainage. Suction drainage of the gallbladder bed does not prevent complications after cholecystectomy: A random control clinical trial Passive tube and suction drainage after elective cholecystectomy--a comparison using ultrasonography. The conduct of cholecystectomy: incision, drainage, bacteriology and postoperative complications. Cholecystectomy with and without intraperitoneal drain. Prospective evaluation of patients with acute cholecystitis treated with percutaneous cholecystostomy and interval laparoscopic cholecystectomy. Cholecystectomy with and without drainage. A randomized, prospective study of 300 patients. Cholecystectomy: to drain or not to drain. A randomized prospective study of 200 patients. Laparoscopic Cholecystectomy for Acute Cholecystitis: Is It Really Safe? Cholecystectomy is safer without drainage: the results of a prospective, randomized clinical trial. Laparoscopic Cholecystectomy for Acute Cholecystitis: Prospective Trial Influence of intraperitoneal drains on subhepatic collections following cholecystectomy: A prospective clinical trial Postoperative ERCP Versus Laparoscopic Choledochotomy for Clearance of Selected Bile Duct Calculi: A Randomized Trial The effect of drains in laparoscopic cholecystectomy. Cholecystectomy and drainage: Ultrasonographic and radioisotopic evaluation [Routine drainage following uncomplicated, elective cholecystectomy? A prospective, randomized study]. Elective cholecystectomy without drainage and without prophylactic antibiotics. A prospective randomized trial with clinical and bacteriological aspects.
Routine drainage of the bed of the gallbladder following  cholecystectomy  remains controversial . A prospect ively r and omized series of 100 instances of cholecystectomy for chronic and subsiding acute cholecystitis are review ed . Postoperative fever was lowered , the need for dressing changes was virtually eliminated and hospital stay was shortened in patients who did not undergo drainage . No complications attributable to drain avoidance were seen Some surgeons drain the gallbladder bed routinely , some selectively and some not at all . We aim ed to clarify this confusion by entering 155 consecutive patients undergoing emergency and elective cholecystectomy without exploration of the common bile duct into a r and om control clinical trial . In 78 patients a 3 mm suction drain was left in the gallbladder bed and in 77 the abdomen was closed without drainage . There were no withdrawals , one death ( in the drainage group ) from myocardial infa rct ion and one intraperitoneal abscess complicating postoperative pancreatitis ( in the no‐drainage group ) . Other events studied were postoperative pyrexia , wound infection , respiratory tract infection and duration of hospital stay . In none of these did the two groups differ either clinical ly or statistically . We conclude that drainage or non‐drainage of the gallbladder bed must remain a matter of individual preference Daily ultrasonography of the gallbladder bed was performed in patients with suction or passive tube drains after elective cholecystectomy . A total of 19 patients was r and omized to suction drainage and 17 to passive tube drainage .  A policy of early drain removal was followed . No significant difference was found between the volume drained and the size of collection detected in either group . Significant bile leaks were detected and were adequately drained by suction and passive tube drains . There were no complications from drains . In view of these findings , we advocate short-term drainage of the gallbladder bed after both open and laparoscopic cholecystectomy using the drain of the surgeon 's choice The benefits of some ancillary techniques of cholecystectomy are exaggerated by retrospective study of selected patients . Therefore , the authors performed a prospect i ve , r and omized study of 100 consecutive patients who underwent simple elective cholecystectomy for chronic cholecystitis and cholelithiasis . No patient was excluded because of incomplete hemostasis or fear of bile leakage . The frequency of pulmonary complications and wound infections was independent of the type of incision -- vertical or subcostal . Peritoneal drainage was found to be unnecessary . Short-term drainage may increase the frequency of postoperative fever , but did not increase pulmonary complications or wound infections . In these patients , intra-abdominal sepsis is rare ; wound infections were uncommon and the gallbladder bile was usually sterile and not the cause of postoperative infection 383 patients undergoing cholecystectomy for non-acute gallbladder pathology were r and omized with regard to the use of an intraperitoneal drain .  187 patients were drained  , 196 patients were not drained . The postoperative course of temperature and liver laboratory tests , the duration of hospital stay and the postoperative morbidity were studied . There were no obviously significant differences between drained and undrained patients . Thus drainage of the subhepatic space after cholecystectomy as performed in this study , could not be associated with any disadvantages for the patient . The advantage of the intraperitoneal drain , could , because of a failing r and omization in 13 % of the patients not be completely evaluated . The preventive effect of the drain with regard to the incidence of postoperative complications however appeared to be very limited . The use of a prophylactic intraperitoneal drain after cholecystectomy could therefore safely be limited to appropriate patients as judged by the operating surgeon BACKGROUND Emergency laparoscopic cholecystectomy has been advocated for the treatment of acute cholecystitis ; however it can be a difficult task , especially in public hospitals , with relatively high conversion and complication rates . Percutaneous cholecystostomy is a simple and effective procedure allowing patients to recover from the acute event and undergo elective laparoscopic surgery at a later stage . METHODS We prospect ively assessed a protocol of initial conservative treatment in patients admitted with acute cholecystitis . Patients who did not respond to medical treatment were treated by percutaneous cholecystostomy .  Following discharge the patients were seen in the outpatient clinic and elective laparoscopic cholecystectomy was considered and scheduled as necessary . The details of the operation were collected with emphasis on complications and conversion rate . RESULTS During a 3-year period , 224 patients who were admitted with acute calculous cholecystitis entered the protocol . Fifty-four patients did not improve under medical treatment and percutaneous cholecystostomy was performed . In spite of adequate drainage , 5 patients still did not improve : 3 patients were successfully operated upon urgently and recovered , while 2 patients who had severe concomitant diseases and multi-organ failure , died . Forty-nine patients were discharged with the catheter and later re-evaluated for elective operation . In 7 patients common bile duct stones were found and were removed by ERCP prior to the elective operation . Twenty-five patients underwent delayed laparoscopic cholecystectomy with a low conversion rate ( 8 % ) , and only minor complications ( 16 % ) . CONCLUSIONS Conservative treatment and delayed operation is still an acceptable choice in the treatment of acute cholecystitis . Percutaneous cholecystostomy is an effective tool , with high success rate and low morbidity , and allows for better pre-operative evaluation of the biliary system and safe interval laparoscopic surgery . Laparoscopic cholecystectomy after drainage of the gall bladder is a low morbidity procedure with relatively low conversion rate A r and omized , prospect i ve study of 300 cholecystectomies was undertaken to evaluate the merits of drainage through a st and ard Penrose or Chaffin-Pratt sump tube matched against no drainage at all . There was no difference in mortality or length of hospital stay . There was , however , a significantly higher incidence of postoperative pyrexia due to atelectasis and wound infection in the drainage groups . Neither drain fulfilled its objective of providing outflow for a subhepatic collection , thus avoiding bile peritonitis . This study suggests that surgical drainage after every uncomplicated cholecystectomy is unnecessary and unwise Abstract During the 24-month period commencing January 1975 , 200 patients underwent elective cholecystectomy for chronic cholecystitis . According to a prospect i ve r and omized protocol , 100 patients were drained and an identical number were not drained . The two groups were similar with respect to age , weight , diabetic history , and all other measured clinical parameters . Patients who were not drained had less postoperative fever in terms of actual temperature elevation and duration of fever and were discharged from the hospital earlier . There was no difference in the incidence of wound infection or other complications between the two groups . This study confirms that elective cholecystectomy without drainage of the subhepatic space can be done safely and that less postoperative fever and shorter hospitalization can be expected Abstract . The prospect ively collected data from 530 cholecystectomies performed in a university clinic from October 1989 to March 1991 were analyzed after 1 to 3 years of follow-up . The aim of this study was to compare the results of laparoscopic cholecystectomy ( LC ) for acute cholecystitis with that for routine symptomatic gallbladders . The preoperative , intraoperative , and postoperative parameters of 424 routine ( noninflamed ) LCs and 54 LCs for acutely inflamed gallbladders were compared under the “ intention to treat ” principle . Operating time was longer in the inflamed group ( median 97 minutes versus 75 minutes;p < 0.0001 ) . Significantly more adhesions ( 20 % versus 8 % ) , more blood loss ( 48 % versus 19 % ) , a higher incidence of bile spillage ( 28 % versus 12 % ) , and lost stones ( 19 % versus 8 % ) were encountered in patients with acute cholecystitis . Common bile duct ( CBD ) injuries were also more frequent in that group ( 5.5 % versus 0.2%;p = 0.005 ) . The rate of conversion to open surgery was higher than with routine LCs ( 13 % versus 4 % ) . There were two deaths in the routine LC group and none in the acutely inflamed group . There was no difference in postoperative pain intensity or postoperative fatigue according to visual analog scale measurements . Patients with acute cholecystitis stayed only 1 day longer ( median 4 days versus 3 days ) in hospital . The quality of life scores indicate return to almost normal values by the 14th postoperative day . Long-term follow-up ( 1–3 years ) did not reveal any delayed clinical adverse effects . In summary , LC for inflamed gallbladders has a higher conversion rate than LC for routine symptomatic gallbladders . If successfully performed , it has definite benefit for the patient in terms of better postoperative recovery . The trade-off is that the risk of CBD injury is significantly higher Drainage after cholecystectomy remains routine despite the lack of scientific supportive data . Numerous clinical studies in the past have attempted to address this controversy but have failed to resolve the issue for different reasons . These include retrospective design , inclusion of only selected cases , and r and omization before surgery . In this study 479 patients undergoing cholecystectomy  were r and omly allocated to a drainage group ( a high-pressure suction drain in Morison 's pouch for 48 hours ) or a nondrainage group . R and omization was performed at the time of peritoneal closure .  All patients undergoing cholecystectomy , both elective and urgent , were included and the operations were performed by all grade s of surgeons . There were two deaths from cardiopulmonary causes , both in the drainage group . No patient required reoperation in either group . The incidence of both wound infections ( 15 vs 5 ; p less than 0.05 ) and chest infections ( 56 vs 19 , p less than 0.02 ) was significantly higher in the drainage group . Three hundred fifty-six patients underwent abdominal ultrasonography 72 hours after surgery . The number of subhepatic fluid collection s thus detected was significantly higher in the patients who received a drain ( 17 vs 6 , p less than 0.05 ) . None of these collection s was clinical ly significant . The postoperative hospital stay was longer in the patients with drains ( 10.3 vs 9.1 days ) , but this difference failed to reach statistical significance . We conclude from this study that the use of a drain after cholecystectomy serves no useful purpose and is potentially harmful . This practice should be ab and oned Abstract . This prospect i ve study determines the indications for and the optimal timing of laparoscopic cholecystectomy ( LC ) following the onset of acute cholecystitis . It also evaluates preoperative and operative factors associated with conversion from laparoscopic cholecystectomy to open cholecystectomy in the presence of acute cholecystitis . Having been established as the procedure of choice for elective cholelithiasis , LC is now also used for management of acute cholecystitis . Under these circumstances the procedure may be difficult and challenging . Certain favorable and unfavorable conditions may be present that influence the conversion and complication rates . Information about these conditions may be helpful for elucidating the optimal circumstances for LC or when the procedure is best avoided . We performed LC on an emergency basis as soon as the diagnosis was made on all patients presenting with acute cholecystitis from January 1994 to December 1995 . All preoperative , operative , and postoperative data were collected on st and ardized forms . Of the 137 patients registered , 130 were eligible for the audit . Seven patients found by laparoscopic intraoperative cholangiography to have choledocholithiasis were converted for common bile duct exploration and were excluded from the study . Altogether 93 patients ( 72 % ) underwent successful LC and 37 ( 28 % ) needed conversion to open cholecystectomy . The conversion rate of acute gangrenous cholecystitis ( 49 % ) was significantly higher than that for uncomplicated acute cholecystitis ( 4.5 % ) ( p < 0.00001 ) and for hydrops ( 28.5 % ) and empyema of the gallbladder ( 28.5 % ) ( p= 0.004 ) . The difference in conversion between the group with acute necrotizing ( gangrenous ) cholecystitis and the two groups with hydrops and empyema of the gallbladder was not statistically significant ( p= 0.07 ) . The complication rates of acute cholecystitis , hydrops , empyema of the gallbladder , and gangrenous cholecystitis were 9.0 % , 9.5 % , 14.0 % , and 20.0 % , respectively ( p= NS ) . Patients with an operative delay of 96 hours or less from the onset of acute cholecystitis had a conversion rate of 23 % , whereas a delay of more than 96 hours was associated with a conversion rate of 47 % ( p= 0.022 ) . The complication rate was 8.5 % in the laparoscopic group and 27 % in the converted group ( p= 0.013 ) . Patients over 65 years of age , with a history of biliary disease , a nonpalpable gallbladder , WBC count over 13,000/cc , and acute gangrenous cholecystitis were independently associated with a high LC conversion rate ; male patients , finding large bile stones , serum bilirubin over 0.8 mg/dl , and WBC count over 13,000/cc were independently associated with a high complication rate following laparoscopic surgery with or without conversion . Generally , LC can be performed safely for acute cholecystitis , with acceptably low conversion and complication rates . Different forms of cholecystitis carry various conversion and complication rates in selected cases . LC for acute cholecystitis should be performed within 96 hours of the onset of disease . Predictors of conversion and complications may be helpful when planning the laparoscopic approach to acute cholecystitis In this prospect i ve r and omized study , the influence of an intraperitoneal drain on the incidence and clinical significance of subhepatic collection s occurring in patients after acute or elective cholecystectomy was assessed by ultrasound examination . A total of 112 patients entered the study , of whom 54 received a drain .  There was no significant difference between the drainage and the non‐drainage groups with respect to mean age or sex distribution , the number of patients in whom the gallbladder bed was formally closed ( 27 versus 21 ) nor in the number of acute cholecystectomies performed in either group ( 12 versus 13 ) . Ultrasound detected 10 ( 18 per cent ) collection s in the drainage group and only one ( 1·8 per cent ) in the non‐drainage group ( P < 0·01 , χ2 test ) . None of the collection s required any further treatment and no morbidity occurred that was directly attributable to the presence of the retained fluid . These results suggest that rather than preventing fluid collection s , suction drains may predispose to the development of subhepatic collection s after cholecystectomy Objective : Prospect ively evaluate whether for patients having laparoscopic cholecystectomy with failed trans-cystic duct clearance of bile duct ( BD ) stones they should have  laparoscopic choledochotomy or postoperative endoscopic retro grade cholangiography ( ERCP ) . Summary Background Data : Clinical management of BD stones found at laparoscopic cholecystectomy in the last decade has focused on pre-cholecystectomy detection with ERCP clearance in those with suspected stones . This clinical algorithm successfully clears the stones in most patients , but no stones are found in 20 % to 60 % of patients and rare unpredictably severe ERCP morbidity can result in this group . Our initial experience of 300 consecutive patients with fluoroscopic cholangiography and intraoperative clearance  demonstrated that , for the pattern of stone disease we see , 66 % of patients ’ BD stones can be cleared via the cystic duct with dramatic reduction in morbidity compared to the 33 % requiring choledochotomy or ERCP . Given the limitations of the preoperative approach to BD stone clearance , this trial was design ed to explore the limitations , for patients failing laparoscopic trans-cystic clearance  , of laparoscopic choledochotomy or postoperative ERCP . Methods : Across 7 metropolitan hospitals after failed trans-cystic duct clearance , patients were intraoperatively r and omized to have either laparoscopic choledochotomy or postoperative ERCP . Exclusion criteria were : ERCP prior to referral for cholecystectomy , severe cholangitis or pancreatitis requiring immediate ERCP drainage , common BD diameter of less than 7 mm diameter , or if bilio-enteric drainage was required in addition to stone clearance . Drain decompression of the cleared BD was used in the presence of cholangitis , an edematous ampulla due to instrumentation or stone impaction and technical difficulties from local inflammation and fibrosis . The ERCP occurred prior to discharge from hospital . Mechanical and extracorporeal shockwave lithotripsy was available . Sphincter balloon dilation as an alternative to sphincterotomy to allow stone extraction was not used . Major endpoints for the trial were operative time , morbidity , retained stone rate , reoperation rate , and hospital stay . Results : From June 1998 to February 2003 , 372 patients with BD stones had successful trans-cystic duct clearance of stones in 286 , leaving 86 patients r and omized into the trial . Total operative time was 10.9 minutes longer in the choledochotomy group ( 158.8 minutes ) , with slightly shorter hospital stay 6.4 days versus 7.7 days . Bile leak occurred in 14.6 % of those having choledochotomy with similar rates of pancreatitis ( 7.3 % versus 8.8 % ) , retained stones ( 2.4 % versus 4.4 % ) , reoperation ( 7.3 % versus 6.6 % ) , and overall morbidity ( 17 % versus 13 % ) . Conclusions : These data suggest that the majority of secondary BD stones can be diagnosed at the time of cholecystectomy and cleared trans-cystically , with those failing having either choledochotomy or postoperative ERCP . However , because of the small trial size , a significant chance exists that small differences in outcome may exist . We would avoid choledochotomy in ducts less than 7 mm measured at the time of operative cholangiogram and severely inflamed friable tissues leading to a difficult dissection . We would advocate choledochotomy as a good choice for patients after Billroth 11 gastrectomy , failed ERCP access , or where long delays would occur for patient transfer to other locations for the ERCP A prospect i ve controlled r and omized study was performed on 100 patients undergoing elective laparoscopic cholecystectomy to evaluate the benefit of routine drainage in simple uncomplicated procedures . The 100 patients were r and omized into two groups . Group 1 patients ( n = 50 ) had a drain placed through the epigastric trocar site . The drain was removed before their discharge unless bile or blood was present . Group 2 patients ( n = 50 ) did not have a drain placed . Eleven patients in group 2 ( no drain ) ( 22 % ) were discharged on the same day of surgery ( within 8 h ) , and the remaining 89 patients in both groups were discharged the day after surgery ( within 23 h ) . There were no wound infections or postoperative fever in either group . There were minor but not statistically significant differences between the two groups in postoperative severity and duration of abdominal pain , shoulder pain , and nausea . Furthermore , the two groups were similar in respect to postoperative recovery time and return to work Eighty patients undergoing cholecystectomy  were either assigned deliberately ( n=30 ) or r and omized ( n=50 ) to drainage ( n=38 ) or nondrainage ( n=42 ) . Subhepatic collection s were seen on ultrasonography ( US ) after 48 to 72 hours in 12 of 35 patients with drainage and 24 of 42 patients without drainage ( p<0.05 ) . Only two patients with subhepatic collection s were symptomatic , and none required treatment . Postoperative infective complications were seen in 13 of 38 patients with drainage and 4 of 42 without drainage ( p<0.01 ) . Five of 12 patients with drainage and with a collection , and none of the 18 patients without drainage and without a collection had postoperative infective complications ( p<0.05 ) . Cholecystectomy was then performed in 100 patients without using a drain . BULIDA radioisotope scans revealed a bile leak in only 4 of 34 patients studied . Subhepatic collection s were seen on US after 48 to 72 hours in 42 patients . The collection resolved in 22 patients and was smaller in 6 on repeat US . None of the patients with collection was symptomatic , and none required treatment . Postoperative infective complications were seen in 7 of 42 patients with a collection and 5 of 58 patients without a collection ( not significant ) . We conclude that ( 1 ) cholecystectomy with drainage is associated with more infective complications than when a drain is not used ; ( 2 ) cholecystectomy without drainage is safe ; and ( 3 ) asymptomatic nonbilious subhepatic collection s are common after cholecystectomy without drainage but do not require treatment , resolving spontaneously . RésuméQuatre-vingt patients ( 50 par r and omisation ) ont eu un drainage ( n=38 ) ou non ( n=42 ) après cholécystectomie traditionnelle . Une collection soushépatique a été mise en évidence par échographie dans les 48–72 heures postopératoires chez 12/35 patients avec drainage et chez 24/42 patients sans drainage ( p < 0.05 ) . Seulement deux de ces collection s étaient symptomatiques et aucune n'a nécessité de geste thérapeutique . Des complications postopératoires infectieuses ont été observées chez 13/38 patients ayant eu un drainage comparées à 4/42 des patients sans drainage ( p<0.01 ) . Cinq des 12 patients ayant eu un drainage et une collection ont eu une infection postopératoire comparés à aucun des 18 patients sans drainage ni collection ( p<0.05 ) . On a ensuite réalisé 100  cholécystectomies sans drainage . Une scintigraphie au technétium a mis en évidence une fuite biliaire chez 4 des 34 patients étudiés . Une collection soushépatique a été mise en évidence par échographie chez 42 patients . Lors de la surveillance échographique , la collection s'est résorbée spontanément chez 22 patients et a diminué d ' importance chez 6 . Aucune de ces collection s n'étaient symptomatiques et aucune n'a nécessité de geste thérapeutique . Des complications postopératoires ont été observés chez 7/42 patients avec une collection comparés à 5/58 patients sans collection ( différence non significative ) . Nous concluons que : ( 1 ) il y a plus d'infection lorsque l'on draine l'abdomen après une cholécystectomie que lorsque l'intervention se termine sans drainage ; ( 2 ) la cholécystectomie sans drainage est sans danger ; et ( 3 ) des collection s bilieuses asymptomatiques sont fréquentes après cholécystectomie sans drainage , mais elles se résorbent habituellement sans nécessiter d'intervention . ResumenOchenta pacientes sometidos a colecistectomía fueron r and omizados a drenaje ( 38 ) o no drenaje ( 42 ) . Se observaron colecciones subhepáticas en ultrasonografía practicada a las 48–72 horas en 12/35 pacientes con drenaje y en 24/42 pacientes sin drenaje ( p<0.05 ) . Sólo 2 de tales colecciones fueron sintomáticas y ninguna requirió tratamiento . Complicaciones sépticas postoperatorias fueron registradas en 13/38 pacientes con drenaje y en 4/42 sin drenaje ( p<0.01 ) . Cinco de 12 con drenaje y con colección subhepática , y ninguno de 18 sin drenaje y sin colección presentaron complicaciones sépticas postoperatorias ( p<0.05 ) . Después de esta serie se practicaron 100 colecistectomías sin drenaje . La escanografía con radioisótopos , BULIDA , reveló escape biliar en sólo 4 de 34 pacientes estudiados ; se visualizaron colecciones subhepáticas por US a las 48–72 horas en 42 pacientes . La colección se resolvió en 22 y apareció menor en 6 casos en que se repitió la US . Ninguna de estas colecciones fue sintomática y ninguna requirió tratamiento alguno . Se registraron complicaciones sépticas en 7/42 pacientes con colección y en 5/58 sin colección ( ns ) . Nuestra conclusión es que la colecistectomía con drenaje se asocia con un numéro mayor de complicaciones sépticas . La colecistectomía libre de drenaje es un procedimiento seguro ; las colecciones no biliares subhepáticas asintomáticas son frecuentes después de la colecistectomía sin drenaje pero no requieren tratamiento y se resuelven espontáneamente A prospect i ve r and omized and controlled study of prophylactic drainage after simple , elective cholecystectomy was carried out . From March 1988 to June 1991 80 patients received an Easy-Flow drain and 80 did not .  Operation and perioperative management were st and ardized . The endpoint of the study was postoperative morbidity , especially postoperative pyrexia and subhepatic fluid collection . The latter was identified by ultrasonography performed daily on postoperative day 1 - 4 . No patient died . The morbidity including postoperative pyrexia revealed no difference between drained and undrained patients . In 19 of the patients with ( 23.8 % ) and in 25 of the patients without drainage ( 31.3 % ) a subhepatic fluid collection could be demonstrated by ultrasonography . This difference was not statistically significant either . We conclude that prophylactic drainage after elective , simple cholecystectomy is of no use for the patient . As subhepatic fluid collection s can be seen in drained as well as in undrained patients it has to be accepted that drainage does not guarantee the removal of subhepatic fluid . Therefore its indicatory function ( bleeding ) and the ability to prevent the patient having biliary peritonitis or local abscess has to be put in doubt A consecutive series of 50 patients undergoing elective cholecystectomy without prophylactic antibiotics  entered a prospect i ve r and omized trial to compare the post-operative clinical course whether the subhepatic space was drained or not . 26 patients ( mean age 58 yrs ) were drained and 24 patients ( mean age 59 yrs ) were not . The incidence of positive gallbladder bile cultures were respectively 8 and 19 % ( N.S. ) in the drained and undrained groups . The incidence of post-operative mortality , thrombo-phlebitis and intra-abdominal sepsis was zero in both groups . In the drained or undrained series , the incidence of wound infection was respectively 4 % and 0 % ( N.S. ) , that of urinary infection was 8 % and 13 % ( N.S. ) and that of pulmonary atelectasis was 15 and 17 % ( N.S. ) . A further consecutive series of 100 undrained elective cholecystectomies ( 18 % positive bile cultures ) without prophylactic antibiotics was then performed with the same uneventful postoperative course . This study therefore indicates that even in the presence of bacterobilia elective cholecystectomy can be safely performed without subhepatic space drainage and without prophylactic antibiotics
We found no significant differences between different types of drains .
Drains increase the harms to the patient without providing any additional benefit for patients undergoing open cholecystectomy and should be avoided in open cholecystectomy
BACKGROUND Cholecystectomy is the removal of gallbladder and is performed mainly for symptomatic gallstones .
Although laparoscopic cholecystectomy is currently preferred over open cholecystectomy for elective cholecystectomy , reports of r and omised clinical trials comparing the choice of cholecystectomy ( open or laparoscopic ) in acute cholecystitis are still being conducted .
Drainage in open cholecystectomy is a matter of considerable debate .
Surgeons use drains primarily to prevent subhepatic abscess or bile peritonitis from an undrained bile leak .
Critics of drain condemn drain use as it increases wound and chest infection .
OBJECTIVES To assess the benefits and harms of routine abdominal drainage in uncomplicated open cholecystectomy .