Clinical significance of drainage tube insertion in laparoscopic cholecystectomy: a prospective randomized controlled trial.

BACKGROUND/PURPOSE: We aimed to investigate the appropriateness of inserting an intraperitoneal drainage tube after laparoscopic cholecystectomy (LC), based on postoperative pain and clinical courses, in a randomized comparative study.

METHODS

One hundred and twenty patients who were to have LC were enrolled in this prospective randomized study. An 8-mm Penrose drain was retained below the liver bed for 42 h in each of 60 patients (group A), and no drain was retained in the remaining 60 patients (group B). Patients in each group were hospitalized for 4 days after operation, and the pain reported by the patients, using a visual analogue pain scale (VAS), and the time courses of changes in the highest body temperature, leukocyte count, and C-reactive protein (CRP) were studied comparatively for men and women.

RESULTS

Mean VAS scores were significantly greater in group A than in group B at 24 h (P = 0.00004), and 48 h (P = 0.0014) after operation. When sex-stratified changes in mean VAS scores were compared within group A, females had more pain than their male counterparts at 24 h (P = 0.030), but group B showed no sex differences. When the number of patients who used analgesics postoperatively was compared between groups A and B, analgesics were used more frequently in group A. When changes in maximum body temperature were compared, the change was significantly higher in group A than in group B on day 2 after the operation (P = 0.017).

CONCLUSIONS

Postoperative pain was intensified by the insertion of a drainage tube after LC. This tendency was stronger in women.