A Randomised Control Trial to Compare Drain Vs No Drain in Elective Laparoscopic Cholecystectomy

Abstract

Background and objectives Laparoscopic cholecystectomy is a safe and effective treatment for patients with gallstones. However, the routine use of drain after laparoscopic cholecystectomy is controversial. The present study was designed to compare drain versus no drain in elective laparoscopic cholecystectomy in terms of morbidity and post operative pain. Methodology The present one year randomized controlled trial was done from January 2013 to December 2013. A total of 60 patients undergoing elective cholecystectomy under the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum were studied. Based on closed envelope method patients were randomized into two groups of 30 each that is, Group D (with drain) and Group ND (without drain). Assessment of pain was done based on VAS scores. Results In group D and group ND, 50% and 40% of the patients were females with male to female ratio of 1:1 and 1:1.5 respectively (p=0.436). The mean age in group D was 43.90 ± 14.06 years compared to 43.30 ± 15.85 years in group ND (p=0.181). The drain volume was found to be 3.06 ± 2.94 mL in a total of 25 numbers of patients. In group D, higher number of patients (83.33%) had collection in either drain or on USG compared to group ND (26.67%) (p<0.001). The mean post operative collection on ultrasound was comparable in both the groups (4.20 ± 1.90 mL vs 4.50 ± 1.92 mL; p=0.181). The mean pain scores were high in group D (6.40 ± 1.83) compared group ND (2.50 ± 1.31) (p<0.001). In group D, mean total collection including drain collection and USG collection was significantly high (10.23 ± 5.40 mL) compared to mean collection on USG in group ND (4.50 ± 1.92 mL) (p<0.001). Conclusion and interpretation Placement of drain in peritoneal cavity following elective laparoscopic cholecystectomy did not have any advantages. Adversely it caused increase in severity of post operative pain.