Gallbladder disease is one of the most common and costly of all digestive diseases. The prevalence of cholecystitis including gallstone increases with age, and laparoscopic cholecystectomy (LC) is recognized as the gold standard surgical treatment .
Drain insertion after LC may be necessary for drainage of intraabdominal fluid collection or for early detection of bleeding and bile leakage. However, drain placement can cause increasing surgical site infections (SSIs) or increased pain.
According to the previous systematic reviews, routine abdominal drainage after elective uncomplicated LC is not recommended [2,3]. Moreover, randomized clinical trials and a recent systematic meta-analysis of reviews have reported that there is no significant benefit in placing a drain for preventing or reducing postoperative morbidities after LC for acute cholecystitis (AC); drain placement may even increase postoperative pain [4,5]. Therefore, drainage after LC is performed to treat an acutely inflamed gallbladder should be avoided, except in unusual cases with intraoperative complications .
Although many studies have demonstrated the disadvantages of drain insertion during LC for AC, the placement of an abdominal drain in complicated LC may be a good choice for reducing or preventing postoperative SSI in clinical practice.
In a current issue article entitled “
This study was a retrospective study comprised of a relatively small sample size and single-center study, which may have introduced surgeon’s selection bias. Furthermore, there was no standard criteria for drain insertion and antibiotics administration. Despite these limitations, the study tried to reduce selection bias through propensity score matching.
However, a large-scale prospective or randomized controlled trial study is warranted for standard drain management of complicated cholecystectomy.
The author has no conflicts of interest to declare.