Cholecystectomy with intraperitoneal drain.

The effects of prophylactic intraperitoneal drainage after cholecystectomy were studied in 389 patients operated upon with elective and in 68 patients operated upon with acute cholecystectomy. The drainage fluid and the duration of drainage were measured and related to clinical variables and postoperative morbidity. The amount of drainage fluid varied from 0 to 1075 ml after elective cholecystectomy and from 5 to 4500 ml after acute cholecystectomy, but there was no statistically significant difference between electively and acutely operated patients. Increased amounts of drainage fluid were significantly more often found in patients with not dry operative field at the end of the operation compared to patients with dry operative field. The maximum daily discharge of drainage fluid occurred during the first and second postoperative day in most patients. The incidence of postoperative morbidity was significantly higher in patients operated upon with acute cholecystectomy. After elective cholecystectomy the postoperative morbidity was significantly increased in patients who drained greater than 150 ml of fluid and also in patients who were drained for three days or more. Relaparotomies because of intraperitoneal hemorrhage and bile leakage or abscess were in spite of intraperitoneal drain performed in six patients after elective cholecystectomy and in one patient after acute cholecystectomy.