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Meta-Analysis
. 2007 Apr 18;2007(2):CD006003.
doi: 10.1002/14651858.CD006003.pub2.

Routine abdominal drainage for uncomplicated open cholecystectomy

K S Gurusamy  1 , K Samraj
Affiliations
Meta-Analysis

Routine abdominal drainage for uncomplicated open cholecystectomy

K S Gurusamy et al. Cochrane Database Syst Rev. .

Abstract

Background: Cholecystectomy is the removal of gallbladder and is performed mainly for symptomatic gallstones. Although laparoscopic cholecystectomy is currently preferred over open cholecystectomy for elective cholecystectomy, reports of randomised clinical trials comparing the choice of cholecystectomy (open or laparoscopic) in acute cholecystitis are still being conducted. Drainage in open cholecystectomy is a matter of considerable debate. Surgeons use drains primarily to prevent subhepatic abscess or bile peritonitis from an undrained bile leak. Critics of drain condemn drain use as it increases wound and chest infection.

Objectives: To assess the benefits and harms of routine abdominal drainage in uncomplicated open cholecystectomy.

Search strategy: We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until April 2006.

Selection criteria: We included randomised clinical trials comparing 'no drain' versus 'drain' in patients who had undergone uncomplicated open cholecystectomy (irrespective of language, publication status, and the type of drain). Randomised clinical trials comparing one drain with another were also included.

Data collection and analysis: We collected the data on the characteristics and methodological quality of each trial, number of abdominal collections requiring different treatments, bile peritonitis, wound infection, chest complications, and hospital stay from each trial. We analysed the data with both the fixed-effect and the random-effects models using RevMan Analysis. For each outcome, we calculated the odds ratio (OR) with 95% confidence intervals (CI) based on intention-to-treat analysis.

Main results: Twenty eight trials involving 3659 patients were included. There were 20 comparisons of 'no drain' versus 'drain' and 12 comparisons of one drain with another. There was no statistically significant difference in mortality, bile peritonitis, total abdominal collections, abdominal collections requiring different treatments, or infected abdominal collections. 'No drain' group had statistically significant lower wound infection (OR 0.61, 95% CI 0.43 to 0.87) and statistically significant lower chest infection (OR 0.59, 95% CI 0.42 to 0.84) than drain group. We found no significant differences between different types of drains.

Authors' conclusions: Drains increase the harms to the patient without providing any additional benefit for patients undergoing open cholecystectomy and should be avoided in open cholecystectomy.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
1.1
1.1. Analysis
Comparison 1 No drain versus drain, Outcome 1 Mortality.
1.2
1.2. Analysis
Comparison 1 No drain versus drain, Outcome 2 Abdominal collections requiring re‐operation.
1.3
1.3. Analysis
Comparison 1 No drain versus drain, Outcome 3 Abdominal collections requiring drain insertion.
1.4
1.4. Analysis
Comparison 1 No drain versus drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
1.5
1.5. Analysis
Comparison 1 No drain versus drain, Outcome 5 Total abdominal collections.
1.6
1.6. Analysis
Comparison 1 No drain versus drain, Outcome 6 Infected intra‐abdominal collections.
1.7
1.7. Analysis
Comparison 1 No drain versus drain, Outcome 7 Bile peritonitis.
1.8
1.8. Analysis
Comparison 1 No drain versus drain, Outcome 8 Wound infection.
1.9
1.9. Analysis
Comparison 1 No drain versus drain, Outcome 9 Chest infection.
1.10
1.10. Analysis
Comparison 1 No drain versus drain, Outcome 10 Atelectasis.
1.11
1.11. Analysis
Comparison 1 No drain versus drain, Outcome 11 Hospital stay (days).
2.1
2.1. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 1 Mortality.
2.2
2.2. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 2 Abdominal collections requiring re‐operation.
2.3
2.3. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 3 Abdominal collections requiring drain insertion.
2.4
2.4. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
2.5
2.5. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 5 Total abdominal collections.
2.6
2.6. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 6 Infected intra‐abdominal collections.
2.7
2.7. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 7 Bile peritonitis.
2.8
2.8. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 8 Wound infection.
2.9
2.9. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 9 Chest infection.
2.10
2.10. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 10 Atelectasis.
2.11
2.11. Analysis
Comparison 2 Subgroup ‐ No drain versus suction drain, Outcome 11 Hospital stay (days).
3.1
3.1. Analysis
Comparison 3 Subgroup ‐ No drain versus passive closed drain, Outcome 1 Mortality.
3.2
3.2. Analysis
Comparison 3 Subgroup ‐ No drain versus passive closed drain, Outcome 2 Total abdominal collections.
3.3
3.3. Analysis
Comparison 3 Subgroup ‐ No drain versus passive closed drain, Outcome 3 Infected intra‐abdominal collections.
3.4
3.4. Analysis
Comparison 3 Subgroup ‐ No drain versus passive closed drain, Outcome 4 Wound infection.
3.5
3.5. Analysis
Comparison 3 Subgroup ‐ No drain versus passive closed drain, Outcome 5 Chest infection.
3.6
3.6. Analysis
Comparison 3 Subgroup ‐ No drain versus passive closed drain, Outcome 6 Atelectasis.
3.7
3.7. Analysis
Comparison 3 Subgroup ‐ No drain versus passive closed drain, Outcome 7 Hospital stay (days).
4.1
4.1. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 1 Mortality.
4.2
4.2. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 2 Abdominal collections requiring re‐operation.
4.3
4.3. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 3 Abdominal collections requiring drain insertion.
4.4
4.4. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
4.5
4.5. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 5 Total abdominal collections.
4.6
4.6. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 6 Infected intra‐abdominal collections.
4.7
4.7. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 7 Bile peritonitis.
4.8
4.8. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 8 Wound infection.
4.9
4.9. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 9 Chest infection.
4.10
4.10. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 10 Atelectasis.
4.11
4.11. Analysis
Comparison 4 Subgroup ‐ No drain versus passive open drain, Outcome 11 Hospital stay (days).
5.1
5.1. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 1 Mortality.
5.2
5.2. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 2 Abdominal collections requiring re‐operation.
5.3
5.3. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 3 Abdominal collections requiring drain insertion.
5.4
5.4. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
5.5
5.5. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 5 Total abdominal collections.
5.6
5.6. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 6 Infected intra‐abdominal collections.
5.7
5.7. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 7 Bile peritonitis.
5.8
5.8. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 8 Wound infection.
5.9
5.9. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 9 Chest infection.
5.10
5.10. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 10 Atelectasis.
5.11
5.11. Analysis
Comparison 5 Subgroup ‐ High methodological quality: no drain versus drain, Outcome 11 Hospital stay (days).
6.1
6.1. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 1 Mortality.
6.2
6.2. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 2 Abdominal collections requiring re‐operation.
6.3
6.3. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 3 Abdominal collections requiring drain insertion.
6.4
6.4. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
6.5
6.5. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 5 Total abdominal collections.
6.6
6.6. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 6 Infected intra‐abdominal collections.
6.7
6.7. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 7 Wound infection.
6.8
6.8. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 8 Chest infection.
6.9
6.9. Analysis
Comparison 6 Subgroup ‐ Routine anitbiotic prophylaxis: no drain versus drain, Outcome 9 Hospital stay (days).
7.1
7.1. Analysis
Comparison 7 Subgroup ‐ No routine anitbiotic prophylaxis: no drain versus drain, Outcome 1 Mortality.
7.2
7.2. Analysis
Comparison 7 Subgroup ‐ No routine anitbiotic prophylaxis: no drain versus drain, Outcome 2 Abdominal collections requiring re‐operation.
7.3
7.3. Analysis
Comparison 7 Subgroup ‐ No routine anitbiotic prophylaxis: no drain versus drain, Outcome 3 Infected intra‐abdominal collections.
7.4
7.4. Analysis
Comparison 7 Subgroup ‐ No routine anitbiotic prophylaxis: no drain versus drain, Outcome 4 Wound infection.
7.5
7.5. Analysis
Comparison 7 Subgroup ‐ No routine anitbiotic prophylaxis: no drain versus drain, Outcome 5 Chest infection.
7.6
7.6. Analysis
Comparison 7 Subgroup ‐ No routine anitbiotic prophylaxis: no drain versus drain, Outcome 6 Atelectasis.
7.7
7.7. Analysis
Comparison 7 Subgroup ‐ No routine anitbiotic prophylaxis: no drain versus drain, Outcome 7 Hospital stay (days).
8.1
8.1. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 1 Mortality.
8.2
8.2. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 2 Abdominal collections requiring re‐operation.
8.3
8.3. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 3 Abdominal collections requiring drain insertion.
8.4
8.4. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
8.5
8.5. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 5 Total abdominal collections.
8.6
8.6. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 6 Infected intra‐abdominal collections.
8.7
8.7. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 7 Bile peritonitis.
8.8
8.8. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 8 Wound infection.
8.9
8.9. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 9 Chest infection.
8.10
8.10. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 10 Atelectasis.
8.11
8.11. Analysis
Comparison 8 Subgroup ‐ Brought out through separate wound: no drain versus drain, Outcome 11 Hospital stay (days).
9.1
9.1. Analysis
Comparison 9 Subgroup ‐ Brought out through main wound: no drain versus drain, Outcome 1 Mortality.
9.2
9.2. Analysis
Comparison 9 Subgroup ‐ Brought out through main wound: no drain versus drain, Outcome 2 Infected intra‐abdominal collections.
9.3
9.3. Analysis
Comparison 9 Subgroup ‐ Brought out through main wound: no drain versus drain, Outcome 3 Wound infection.
9.4
9.4. Analysis
Comparison 9 Subgroup ‐ Brought out through main wound: no drain versus drain, Outcome 4 Atelectasis.
10.1
10.1. Analysis
Comparison 10 Subgroup ‐ Emergency cholecystectomy: no drain versus drain, Outcome 1 Abdominal collections requiring re‐operation.
10.2
10.2. Analysis
Comparison 10 Subgroup ‐ Emergency cholecystectomy: no drain versus drain, Outcome 2 Abdominal collections requiring drain insertion.
10.3
10.3. Analysis
Comparison 10 Subgroup ‐ Emergency cholecystectomy: no drain versus drain, Outcome 3 Abdominal collections requiring percutaneous aspiration.
10.4
10.4. Analysis
Comparison 10 Subgroup ‐ Emergency cholecystectomy: no drain versus drain, Outcome 4 Wound infection.
10.5
10.5. Analysis
Comparison 10 Subgroup ‐ Emergency cholecystectomy: no drain versus drain, Outcome 5 Chest infection.
11.1
11.1. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 1 Mortality.
11.2
11.2. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 2 Abdominal collections requiring re‐operation.
11.3
11.3. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 3 Abdominal collections requiring drain insertion.
11.4
11.4. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
11.5
11.5. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 5 Total abdominal collections.
11.6
11.6. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 6 Infected intra‐abdominal collections.
11.7
11.7. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 7 Bile peritonitis.
11.8
11.8. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 8 Wound infection.
11.9
11.9. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 9 Chest infection.
11.10
11.10. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 10 Atelectasis.
11.11
11.11. Analysis
Comparison 11 Subgroup ‐ Elective cholecystectomy: no drain versus drain, Outcome 11 Hospital stay (days).
12.1
12.1. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 1 Mortality.
12.2
12.2. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 2 Abdominal collections requiring re‐operation.
12.3
12.3. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 3 Abdominal collections requiring drain insertion.
12.4
12.4. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 4 Abdominal collections requiring percutaneous aspiration.
12.5
12.5. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 5 Total abdominal collections.
12.6
12.6. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 6 Infected intra‐abdominal collections.
12.7
12.7. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 7 Bile peritonitis.
12.8
12.8. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 8 Wound infection.
12.9
12.9. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 9 Chest infection.
12.10
12.10. Analysis
Comparison 12 No drain versus drain (Risk difference), Outcome 10 Atelectasis.
13.1
13.1. Analysis
Comparison 13 Suction drain versus passive closed drain, Outcome 1 Mortality.
13.2
13.2. Analysis
Comparison 13 Suction drain versus passive closed drain, Outcome 2 Total abdominal collections.
13.3
13.3. Analysis
Comparison 13 Suction drain versus passive closed drain, Outcome 3 Wound infection.
13.4
13.4. Analysis
Comparison 13 Suction drain versus passive closed drain, Outcome 4 Chest infection.
13.5
13.5. Analysis
Comparison 13 Suction drain versus passive closed drain, Outcome 5 Pain at drain site.
14.1
14.1. Analysis
Comparison 14 Subgroup ‐ Emergency cholecystectomy: suction drain versus passive closed drain, Outcome 1 Mortality.
15.1
15.1. Analysis
Comparison 15 Subgroup ‐ Elective cholecystectomy: suction drain versus passive closed drain, Outcome 1 Mortality.
15.2
15.2. Analysis
Comparison 15 Subgroup ‐ Elective cholecystectomy: suction drain versus passive closed drain, Outcome 2 Total abdominal collections.
15.3
15.3. Analysis
Comparison 15 Subgroup ‐ Elective cholecystectomy: suction drain versus passive closed drain, Outcome 3 Wound infection.
15.4
15.4. Analysis
Comparison 15 Subgroup ‐ Elective cholecystectomy: suction drain versus passive closed drain, Outcome 4 Chest infection.
15.5
15.5. Analysis
Comparison 15 Subgroup ‐ Elective cholecystectomy: suction drain versus passive closed drain, Outcome 5 Pain at drain site.
16.1
16.1. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 1 Mortality.
16.2
16.2. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 2 Abdominal collections requiring re‐operation.
16.3
16.3. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 3 Abdominal collections requiring drain insertion.
16.4
16.4. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
16.5
16.5. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 5 Total abdominal collections.
16.6
16.6. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 6 Infected abdominal collections.
16.7
16.7. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 7 Bile peritonitis.
16.8
16.8. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 8 Wound infection.
16.9
16.9. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 9 Chest infection.
16.10
16.10. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 10 Atelectasis.
16.11
16.11. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 11 Pain at drain site.
16.12
16.12. Analysis
Comparison 16 Suction drain versus passive open drain, Outcome 12 Hospital stay (days).
17.1
17.1. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 1 Mortality.
17.2
17.2. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 2 Abdominal collections requiring re‐operation.
17.3
17.3. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 3 Abdominal collections requiring drain insertion.
17.4
17.4. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 4 Abdominal collections requiring percutaneous aspiration.
17.5
17.5. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 5 Total abdominal collections.
17.6
17.6. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 6 Bile peritonitis.
17.7
17.7. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 7 Wound infection.
17.8
17.8. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 8 Chest infection.
17.9
17.9. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 9 Atelectasis.
17.10
17.10. Analysis
Comparison 17 Subgroup ‐ Elective cholecystectomy: suction drain versus passive open drain, Outcome 10 Hospital stay (days).
18.1
18.1. Analysis
Comparison 18 High suction drain versus low suction drain, Outcome 1 Wound infection.
18.2
18.2. Analysis
Comparison 18 High suction drain versus low suction drain, Outcome 2 Chest infection.
19.1
19.1. Analysis
Comparison 19 Large bore suction drain versus small bore suction drain, Outcome 1 Abdominal collections requiring re‐operation.
19.2
19.2. Analysis
Comparison 19 Large bore suction drain versus small bore suction drain, Outcome 2 Total abdominal collections.
19.3
19.3. Analysis
Comparison 19 Large bore suction drain versus small bore suction drain, Outcome 3 Chest infection.
20.1
20.1. Analysis
Comparison 20 Disposable suction drain verus re‐usable suction drain, Outcome 1 Total abdominal collections.
20.2
20.2. Analysis
Comparison 20 Disposable suction drain verus re‐usable suction drain, Outcome 2 Wound infection.
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Update of

References

References to studies included in this review

Adloff 1987 {published data only}
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Latif 1989 {published data only}
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McCormack 1983 {published data only}
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Monson 1991 {published data only}
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Playforth 1985 {published data only}
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Porati 1984 {published data only}
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Saad 1993 {published data only}
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Salam 1984 {published data only}
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Sarr 1987 {published data only}
    1. Sarr MG, Parikh KJ, Minken SL, Zuidema GD, Cameron JL. Closed‐suction versus Penrose drainage after cholecystectomy. A prospective, randomized evaluation. The American Journal of Surgery 1987;153(4):394‐8. - PubMed
Schaupp 1988 {published data only}
    1. Schaupp W, Menges HW, Schworm HD. The "ideal" cholecystectomy. A prospective, randomized study. Der Chirurg 1988;59(10):661‐4. - PubMed
Trowbridge 1982 {published data only}
    1. Trowbridge PE. A randomized study of cholecystectomy with and without drainage. Surgery, Gynecology & Obstetrics 1982;155(2):171‐6. - PubMed
van der Linden 1980 {published data only}
    1. Linden W, Gedda S, Edlund G. Randomized trial of drainage after cholecystectomy. Suction versus static drainage through a main wound versus a stab incision. American Journal of Surgery 1980;141(2):289‐94. - PubMed

References to studies excluded from this review

Diez 1990 {published data only}
    1. Diez JA, Pujato MR, Ferreres AR. The need of drainage after cholecystectomy. HPB Surgery: a World Journal of Hepatic, Pancreatic and Biliary Surgery 1990;3(1):5‐10. - PMC - PubMed
Farha 1981 {published data only}
    1. Farha GJ, Chang FC, Matthews EH. Drainage in elective cholecystectomy. American Journal of Surgery 1981;142(6):678‐80. - PubMed
Gupta 1978 {published data only}
    1. Gupta S, Rauscher G, Stillman R, Fitzerald J, Powers J. The rational use of drains after cholecystectomy. Surgery, Gynecology & Obstetrics 1978;146(2):191‐2. - PubMed
Hanna 1970 {published data only}
    1. Hanna E. Efficiency of peritoneal drainage. Surgery, Gynecology & Obstetrics 1970;131(5):983‐5. - PubMed
Irwin 1988 {published data only}
    1. Irwin ST, Moorehead RJ, Parks TG. Effect of drainage on subhepatic collections and respiratory function after elective cholecystectomy. The British Journal of Surgery 1988;75(5):476. - PubMed
Jha 1986 {published data only}
    1. Jha IN, Singh HB, Prasad N. Clinical trial of drainage following cholecystectomy: suction versus static drainage. Journal of the Indian Medical Association 1986;84(11):341‐2. - PubMed
Kapoor 1993 {published data only}
    1. Kapoor VK, Ibrarullah M, Baijal SS, Kulshreshtha A, Mittal BR, Saxena R, et al. Cholecystectomy and drainage: ultrasonographic and radioisotopic evaluation. World Journal of Surgery 1993;17(1):101‐4. - PubMed
Maull 1978 {published data only}
    1. Maull KI, Daugherty ME, Shearer GR, Sachatello CR, Ernst CB, Meeker WR, et al. Cholecystectomy: to drain or not to drain. A randomized prospective study of 200 patients. The Journal of Surgical Research 1978;24(4):259‐63. - PubMed
Maull 1981 {published data only}
    1. Maull KI, Shirazi KK, Whitley RE, Halloran LG, Gayle WE, Haynes BW. The effect of prophylactic drainage on sub‐hepatic fluid collections after elective cholecystectomy ‐ a prospective randomized ultrasonographic study. American Surgeon 1981;47(2):85‐8. - PubMed
Peer 1993 {published data only}
    1. Peer GQ, Wani NA. Role of intraperitoneal drains on subhepatic collection following routine uncomplicated cholecystectomy. Journal of the Indian Medical Association 1993;91(7):175‐6. - PubMed
Ragoonanan 1983 {published data only}
    1. Ragoonanan C, Crosby DL, Morgan WP, Rees BI. Peritoneal drainage following cholecystectomy: a controlled trial. Annals of the Royal College of Surgeons of England 1983;65(6):403. - PMC - PubMed
Rivas 1980 {published data only}
    1. Rivas A, Holliday H, Wright J. Cholecystectomy with closed suction drainage. Southern Medical Journal 1980;73(2):161‐2. - PubMed
Salam 1994 {published data only}
    1. Salam IM. Passive tube and suction drainage after elective cholecystectomy: a comparison using ultrasonography. Journal of the Royal College of Surgeons of Edinburgh 1994;39(2):134‐5. - PubMed
Salles 1992 {published data only}
    1. Salles RA, Santos Jr AP, Freitas RG, Silva ML, Coelho CA. Cholecystectomy with or without drainage. Revista do Colegio Brasileiro de Cirurgioes 1992;19(6):269‐71.
Shirazi 1982 {published data only}
    1. Shirazi KK, Maull KI. Subhepatic sonography following cholecystectomy. Journal of Ultrasound in Medicine 1982;1(7):271‐3. - PubMed
Stone 1978 {published data only}
    1. Stone HH, Hooper CA, Millikan WJ Jr. Abdominal drainage following appendectomy and cholecystectomy. Annals of Surgery 1978;187(6):606‐12. - PMC - PubMed
Truedson 1983 {published data only}
    1. Truedson H. Cholecystectomy with and without intraperitoneal drain. Acta Chirurgica Scandinavica 1983;149(4):393‐9. - PubMed
van der Linden 1981 {published data only}
    1. Linden W, Gedda S, Edlund G. Sump drainage versus static drainage after cholecystectomy. Surgery, Gynecology & Obstetrics 1981;152(6):829‐30. - PubMed

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