Study to Assess Post-Operative Outcome in Patients Undergoing Elective Laparoscopic Cholecystectomy with or Without Drain

Abstract

Introduction: Laparoscopic cholecystectomy is the gold standard for managing gallbladder pathologies due to its minimally invasive nature, which offers benefits such as reduced postoperative pain, smaller scars, shorter hospital stays, and quicker recovery. Despite these advantages, postoperative issues such as shoulder tip pain, nausea, and vomiting can occur. Traditionally, drains have been used to mitigate complications related to pneumoperitoneum and prevent fluid collections like bilomas or hematomas. However, recent studies suggest that drains may increase postoperative complications and prolong hospital stays, raising questions about their routine use. Objective: To evaluate the impact of drain placement versus no drain on postoperative outcomes in patients undergoing elective laparoscopic cholecystectomy. Methods: This was a prospective comparative study conducted at the Department of General Surgery, AVMCH, from September 2022 to June 2024, among 68 patients. Participants were divided into two groups—drain and no drain—based on their treatment protocol. Data were collected through detailed history-taking, clinical examinations, and relevant investigations. Postoperative outcomes such as pain, fever, nausea, vomiting, fluid collection, wound infections, and hospital stay were assessed. Statistical analysis was performed using SPSS v23.0 with significance set at p<0.05. Results: The study found no significant differences in baseline characteristics or intraoperative variables between the groups. However, the drain group exhibited significantly (p<0.05) higher postoperative pain scores, increased incidence of fever, nausea, vomiting, and wound infections, and a longer hospital stay compared to the no-drain group. Conclusion: Patients undergoing elective laparoscopic cholecystectomy without a drain experienced better postoperative outcomes, including reduced pain, fewer complications, and shorter hospital stays.