Anindita Bhar1, Sagar Karmakar2
BACKGROUND The disease of gallbladder is one of the most common abdominal ailment encountered by the surgeons since ancient times for which cholecystectomy is the most commonly performed operation. In the late 19th century, first successful open cholecystectomy was performed by Carl Langenbuch using aseptic technique, thereafter in the last 100 years, open cholecystectomy has remained the gold standard for definitive management of symptomatic cholelithiasis. It was a common practice to give a routine drain in each and every case of cholecystectomy, but Spivak and many other authors have advocated operation without drain which has dramatically reduced postoperative morbidity and hospital stay. AIM The aim of the study was to compare the postoperative complications such as pain, wound infection, respiratory complications, and incidence of postoperative thrombophlebitis, subhepatic collection and length of hospital stay in patients who have undergone open cholecystectomy with drain with those without drain. DESIGN This is a prospective longitudinal interventional study. MATERIALS AND METHODS This study was done in 70 patients admitted for cholecystectomy operation in Surgery Department of Midnapore Medical College. 35 of them selected randomly were assigned as Group A who were given a postoperative drain and rest 35 patients assigned Group B were without drain. The presence of postoperative complications such as pain, wound infection, respiratory complications (cough, breathing difficulty, pneumonitis, and pulmonary embolism), thrombophlebitis, subhepatic collection and length of hospital stay were compared between the two groups. RESULT 91.42% patients of Group A had a significant pain compared to 51.42% patients of Group B. Wound infection and respiratory complications were present in 14.28% cases of Group A as against 5.71% cases in Group B. Fever was present in 42.85%, thrombophlebitis in 25.71% and subhepatic collection in 28.57% of patients of Group A compared to 8.57% fever cases and 5.71% cases of thrombophlebitis and subhepatic collection in Group B. CONCLUSION Drainage after simple cholecystectomy in the absence of definite indications is unnecessary and may be associated with higher incidence of morbidity.
