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To drain or not to drain elective uncomplicated laparoscopic cholecystectomy? A systematic review and meta‐analysis
Author(s) -
Bugiantella Walter,
Vedovati Maria Cristina,
Becattini Cecilia,
Canger Ruben Carlo Balzarotti,
Avenia Nicola,
Rondelli Fabio
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.127
Subject(s) - medicine , meta analysis , cochrane library , cholecystectomy , incidence (geometry) , randomized controlled trial , drainage , laparoscopic cholecystectomy , surgery , abdominal pain , medline , general surgery , ecology , physics , political science , law , optics , biology
Laparoscopic cholecystectomy ( LC ) has largely replaced conventional cholecystectomy in the past decade. However, there are still limited data about the value of prophylactic sub‐hepatic drainage for elective uncomplicated LC . We carried out a systematic review of the literature in order to perform a meta‐analysis about this issue. An unrestricted search in MEDLINE , EMBASE and Cochrane Library up to 31 D ecember 2013 was performed. Overall, seven high‐methodological quality randomized controlled trials ( RCT s) were included in the meta‐analysis, resulting in 1310 patients totally. The incidence of abdominal collections, wound infection and overall mortality according to the presence or absence of the sub‐hepatic drainage were meta‐analyzed. Sub‐hepatic drainage showed an increase in the abdominal collection rate in patients who underwent elective uncomplicated LC ( OR 1.56, 95% CI 1.00–2.43) if compared to patients without drainage. A non‐significant correlation was found in overall mortality and infection rates. The meta‐analysis shows that the presence of the sub‐hepatic drainage does not reduce the incidence of abdominal collection after uncomplicated LC , whereas it does not influence wound infection and mortality rates, postoperative pain and hospital stay.