OPEN CHOLECYSTECTOMY WITHOUT INTRAPERITONEAL DRAINAGE
Abstract
Background: Cholecystectomy through laparotomy with or without intra-peritoneal drain has beenthe standard operation for the gall bladder disease for the last 100 years. It implies removal of gallbladder and is performed mainly for symptomatic gall stones. The Objectives was to analyse theoutcome of open cholecystectomy without drain in term of complications. Methods: Patients whounderwent open cholecystectomy without drainage from January 2005 to December 2008, atDepartment of Surgery, Liaquat University Hospital, Jamshoro, Pakistan were included in the study.This was a 4 years prospective analysis of open cholecystectomy performed without drainage on 212patients. Patients were randomly allocated for the procedure who presented with uncomplicatedCholelithiasis. Exclusion Criteria included carcinoma gall bladder, empyema gall bladder,Choledocholithiasis and porcelain gall bladder. All these patients underwent open cholecystectomyunder general anaesthesia through various incisions. Operative time, post operative complicationsand hospital stay were recorded on a performa and analysed using SPSS-13. Results: Two hundredand twelve patients, 199 females (93.9%) and 13 males (6.13%), age range 15 to 70 years, underwentopen cholecystectomy without drainage for uncomplicated cholelithiasis. The most commoncomplication observed includes seroma (5.66%), followed by surgical site infection both superficialand deep (3.30%) and bile leakage (1.14%). However biliary peritonitis, sub hepatic abscess andWattman Walter’s syndrome were not observed in any case. Mean operating time was 35 minutes.Mean hospital stay was 1.5 days with no mortality during the period of hospitalisation. The overallcomplications rate and hospital stay was significantly less when compared to open cholecystectomywith intra-peritoneal drain. Conclusion: In selected cases with a dry gall bladder bed, routine use ofintra peritoneal drainage is unnecessary.Keywords: open cholecystectomy, intra peritoneal drain, complicationsReferences
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