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Drainage versus no drainage after laparoscopic cholecystectomy for acute cholecystitis: a meta-analysis

Wenjie Huang, Liying Ying, Yuzhu Jia

Objective: To conduct a Randomized Controlled Trial (RCT) meta-analysis to assess the effectiveness of drains in reducing complications after Laparoscopic Cholecystectomy (LC) for acute cholecystitis.

Methods: An electronic search of PubMed, EMBase, Science Citation Index, and the Cochrane Library from January 1990 to January 2016 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in LC for acute cholecystitis. The outcomes were calculated as Odds Ratios (ORs) with 95% Confidence Intervals (CIs) using RevMan 5.2.

Results: Three RCTs, which included 382 patients, were identified for analysis in our study. There was no statistically significant different in the rate of morbidities (OR=1.23, 95% CI 0.55-2.76, P=0.61). Abdominal pain 24 h after surgery was more severe in the drain group (MD=0.80, 95% CI 0.47-1.14; P<0.00001). No significant difference was present with respect to wound infection rate and hospital stay.

Conclusion: Placement of drain is not beneficial for the prevention or reduction of postoperative morbidities after emergent laparoscopic cholecystectomy and can even increase postoperative pain.