Comparison of Postoperative Outcomes of Laparoscopic Cholecystectomy with or without Abdominal Prophylactic Drainage: A Prospective Interventional Study

Abstract

Introduction: With increasing surgeon experience and advancements in instrumentation and equipment, Laparoscopic Cholecystectomy (LC) continues to progress as a safer and less invasive procedure. Drainage should not be regarded as obligatory or standard after elective LC, according to the majority. Aim: To evaluate the efficacy of elective LC with and without abdominal drainage and to compare the postoperative outcomes among the groups. Materials and Methods: This prospective interventional study was carried out among all patients admitted for elective LC at the Department of Surgery, Era’s Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India from October 2022 to July 2023. A total of 200 patients scheduled for LC were divided into a drain group (n=92) or a no-drain group (n=108). Allocation was non randomised and based on surgeon preference. Along with demographics, surgical details including operation time, estimated blood loss, time to first flatus and tolerance of water and solid nutrition, postoperative hospital stay duration, and postoperative complications were noted and compared. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software (SPSS Inc., Chicago, IL, USA) for the Windows program (version 26.0). The continuous and dichotomous variables were evaluated using student’s t-test and Chi-square test. Results: The mean age of patients in the drain and no-drain groups was 57.18±14.39 years and 55.61±14.83 years, respectively, with a female predominance. The no-drain group had a significantly shorter mean operation time than the drain group (93.27±30.81 min vs 124.86±38.64 min). Hospital stays in the no-drain group were substantially shorter (5.47±2.61 days) than those in the drain group (7.56±3.91 days). The postoperative morbidity rates were 14 (15.22%) in the drain group and 10 (9.26%) in the no-drain group. There was no significant difference between the groups in terms of postoperative complications. During the study, no patients in either group required reoperation. The most frequently cited reasons for drain placement were intraoperative haemorrhage (n=11) and difficult operation (n=11). Conclusion: The use of drains after simple, elective, uncomplicated LC could be safely restricted to patients deemed appropriate by the surgeon. Regarding postoperative complications, the no-drain group is superior in its use.