Ronaghan J E, Miller S F, Finley R K, Jones L M, Elliott D W
Surg Gynecol Obstet. 1986 Mar;162(3):253-5.
A retrospective review is undertaken to evaluate the effects of drainage versus nondrainage of the gallbladder bed after elective cholecystectomy. Two hundred charts of patients who underwent elective cholecystectomy without choledochotomy were reviewed. Patient selection was based upon several criteria: elective cholecystectomy, lack of explorations of the common duct and lack of associated surgical procedures. Two equal groups were analyzed. Those who had postoperative drainage of the subhepatic space and those who did not have drainage. Postoperative length of stay, maximum postoperative temperature elevation and the number of postoperative analgesics were significantly higher (p less than 0.001) in the drainage group. The rate of progression to regular diet was significantly faster in the nondrainage group (p less than 0.001) and the number of complications was higher in the drainage group (p less than 0.05). No complications were noted due to the lack of drain placement. It was concluded that routine drainage of the subhepatic space after elective cholecystectomy without choledochotomy is unnecessary and contributes to increased postoperative morbidity, length of hospital stay and a higher rate of complications.
进行一项回顾性研究以评估择期胆囊切除术后胆囊床引流与不引流的效果。回顾了200例未行胆总管切开术的择期胆囊切除术患者的病历。患者选择基于以下几个标准:择期胆囊切除术、未探查胆总管以及未进行相关外科手术。分析了两个相等的组。一组为术后行肝下间隙引流的患者,另一组为未行引流的患者。引流组的术后住院时间、术后最高体温升高幅度和术后镇痛药使用次数显著更高(p<0.001)。不引流组恢复正常饮食的速度显著更快(p<0.001),引流组的并发症数量更高(p<0.05)。未发现因未放置引流管而导致的并发症。得出的结论是,在未行胆总管切开术的择期胆囊切除术后常规引流肝下间隙是不必要的,且会导致术后发病率增加、住院时间延长和并发症发生率升高。