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Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy

BACKGROUND AND OBJECTIVES: Routine drainage after laparoscopic cholecystectomy is still controversial. This meta-analysis was performed to assess the role of drains in reducing complications in laparoscopic cholecystectomy. METHODS: An electronic search of Medline, Science Citation Index Expanded, S...

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Autores principales: Picchio, Marcello, Lucarelli, Pierino, Di Filippo, Annalisa, De Angelis, Francesco, Stipa, Francesco, Spaziani, Erasmo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266231/
https://www.ncbi.nlm.nih.gov/pubmed/25516708
http://dx.doi.org/10.4293/JSLS.2014.00242
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author Picchio, Marcello
Lucarelli, Pierino
Di Filippo, Annalisa
De Angelis, Francesco
Stipa, Francesco
Spaziani, Erasmo
author_facet Picchio, Marcello
Lucarelli, Pierino
Di Filippo, Annalisa
De Angelis, Francesco
Stipa, Francesco
Spaziani, Erasmo
author_sort Picchio, Marcello
collection PubMed
description BACKGROUND AND OBJECTIVES: Routine drainage after laparoscopic cholecystectomy is still controversial. This meta-analysis was performed to assess the role of drains in reducing complications in laparoscopic cholecystectomy. METHODS: An electronic search of Medline, Science Citation Index Expanded, Scopus, and the Cochrane Library database from January 1990 to June 2013 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in laparoscopic cholecystectomy. The odds ratio for qualitative variables and standardized mean difference for continuous variables were calculated. RESULTS: Twelve randomized controlled trials were included in the meta-analysis, involving 1939 patients randomized to a drain (960) versus no drain (979). The morbidity rate was lower in the no drain group (odds ratio, 1.97; 95% confidence interval, 1.26 to 3.10; P = .003). The wound infection rate was lower in the no drain group (odds ratio, 2.35; 95% confidence interval, 1.22 to 4.51; P = .01). Abdominal pain 24 hours after surgery was less severe in the no drain group (standardized mean difference, 2.30; 95% confidence interval, 1.27 to 3.34; P < .0001). No significant difference was present with respect to the presence and quantity of subhepatic fluid collection, shoulder tip pain, parenteral ketorolac consumption, nausea, vomiting, and hospital stay. CONCLUSION: This study was unable to prove that drains were useful in reducing complications in laparoscopic cholecystectomy.
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spelling pubmed-42662312014-12-16 Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy Picchio, Marcello Lucarelli, Pierino Di Filippo, Annalisa De Angelis, Francesco Stipa, Francesco Spaziani, Erasmo JSLS Scientific Papers BACKGROUND AND OBJECTIVES: Routine drainage after laparoscopic cholecystectomy is still controversial. This meta-analysis was performed to assess the role of drains in reducing complications in laparoscopic cholecystectomy. METHODS: An electronic search of Medline, Science Citation Index Expanded, Scopus, and the Cochrane Library database from January 1990 to June 2013 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in laparoscopic cholecystectomy. The odds ratio for qualitative variables and standardized mean difference for continuous variables were calculated. RESULTS: Twelve randomized controlled trials were included in the meta-analysis, involving 1939 patients randomized to a drain (960) versus no drain (979). The morbidity rate was lower in the no drain group (odds ratio, 1.97; 95% confidence interval, 1.26 to 3.10; P = .003). The wound infection rate was lower in the no drain group (odds ratio, 2.35; 95% confidence interval, 1.22 to 4.51; P = .01). Abdominal pain 24 hours after surgery was less severe in the no drain group (standardized mean difference, 2.30; 95% confidence interval, 1.27 to 3.34; P < .0001). No significant difference was present with respect to the presence and quantity of subhepatic fluid collection, shoulder tip pain, parenteral ketorolac consumption, nausea, vomiting, and hospital stay. CONCLUSION: This study was unable to prove that drains were useful in reducing complications in laparoscopic cholecystectomy. Society of Laparoendoscopic Surgeons 2014 /pmc/articles/PMC4266231/ /pubmed/25516708 http://dx.doi.org/10.4293/JSLS.2014.00242 Text en © 2014 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Picchio, Marcello
Lucarelli, Pierino
Di Filippo, Annalisa
De Angelis, Francesco
Stipa, Francesco
Spaziani, Erasmo
Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy
title Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy
title_full Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy
title_fullStr Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy
title_full_unstemmed Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy
title_short Meta-Analysis of Drainage Versus No Drainage After Laparoscopic Cholecystectomy
title_sort meta-analysis of drainage versus no drainage after laparoscopic cholecystectomy
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4266231/
https://www.ncbi.nlm.nih.gov/pubmed/25516708
http://dx.doi.org/10.4293/JSLS.2014.00242
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