Abstract:
BACKGROUND:There is paucity of evidence regarding the role of drain in laparoscopic cholecystectomy (LC) in acute calculous cholecystitis (ACC), and surgeons have placed the drains based on their experiences, not on evidence-based guidelines. This study aims to assess the value of drain in LC for ACC in a randomised controlled prospective study. PATIENTS AND METHODS:All patients with mild and moderate ACC undergoing LC were assessed. Preoperatively, patients with choledocholithiasis, Mirizzi syndrome and biliary stent were excluded. Intraoperatively or postoperatively, patients with complications, partial cholecystectomies and malignancies were excluded. Patients were randomised using computer-generated random numbers into two groups at the end of cholecystectomy before closure. Requirement of radiologically guided (ultrasonography () or CT) percutaneous aspiration/drainage of symptomatic intra-abdominal collection or reoperation; continuation of parenteral antibiotics beyond 24 hours or change in antibiotics empirically or based on peritoneal fluid culture sensitivity; requirement of postoperative USG or CT scan based on postoperative clinical course; wound infection rates; postoperative pain using numeric rating scale at 6 and 24 hours; and the duration of hospital stay in both groups were noted. RESULTS:Forty-two out of 50 consecutive patients were randomised into two equal groups. Pain score at 6 and 24 hours was less in patients without drain. All other complication rates and duration of stay were similar in both groups. CONCLUSIONS:Drains should not be placed routinely after LC in ACC as it increases pain and does not help in detecting or decreasing complications.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Valappil MV,Gulati S,Chhabra M,Mandal A,Bakshi S,Bhattacharyya A,Ghatak Sdoi
10.1136/postgradmedj-2019-136828subject
Has Abstractpub_date
2020-10-01 00:00:00pages
606-609issue
1140eissn
0032-5473issn
1469-0756pii
postgradmedj-2019-136828journal_volume
96pub_type
杂志文章abstract::A patient with long-standing ischaemic heart disease and severe low output congestive cardiac failure received numerous diuretics, which gradually became ineffective. Resistant oedema was treated by adding demeclocycline to the current diuretic regime of frusemide and metolazone. Diuresis resulted, oedema disappeared ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.652.121
更新日期:1980-02-01 00:00:00
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journal_title:Postgraduate medical journal
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journal_title:Postgraduate medical journal
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更新日期:1979-09-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析,评审
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1984-02-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
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更新日期:1989-12-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1977-02-01 00:00:00
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pub_type: 杂志文章,多中心研究
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journal_title:Postgraduate medical journal
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pub_type: 杂志文章
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更新日期:1998-09-01 00:00:00