Cholecystectomy and drainage: ultrasonographic and radioisotopic evaluation.

Abstract:

:Eighty patients undergoing cholecystectomy were either assigned deliberately (n = 30) or randomized (n = 50) to drainage (n = 38) or nondrainage (n = 42). Subhepatic collections were seen on ultrasonography (US) after 48 to 72 hours in 12 of 35 patients with drainage and 24 of 42 patients without drainage (p < 0.05). Only two patients with subhepatic collections were symptomatic, and none required treatment. Postoperative infective complications were seen in 13 of 38 patients with drainage and with a collection, and none of the 18 patients without drainage and without a collection had postoperative infective complications (p < 0.05). Cholecystectomy was then performed in 100 patients without using a drain. BULIDA radioisotope scans revealed a bile leak in only 4 of 34 patients studied. Subhepatic collections were seen on US after 48 to 72 hours in 42 patients. The collection resolved in 22 patients and was smaller in 6 on repeat US. None of the patients with collection was symptomatic, and none required treatment. Postoperative infective complications were seen in 7 of 42 patients with a collection and 5 of 58 patients without a collection (not significant). We conclude that (1) cholecystectomy with drainage is associated with more infective complications than when a drain is not used; (2) cholecystectomy without drainage is safe; and (3) asymptomatic nonbilious subhepatic collections are common after cholecystectomy without drainage but do not require treatment, resolving spontaneously.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Kapoor VK,Ibrarullah M,Baijal SS,Kulshreshtha A,Mittal BR,Saxena R,Das BK,Kaushik SP

doi

10.1007/BF01655718

subject

Has Abstract

pub_date

1993-01-01 00:00:00

pages

101-4

issue

1

eissn

0364-2313

issn

1432-2323

journal_volume

17

pub_type

临床试验,杂志文章,随机对照试验
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