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Optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study

PURPOSE: This study was performed to investigate the effect of drain placement on complicated laparoscopic cholecystectomy (cLC) for acute cholecystitis (AC). METHODS: This single-center retrospective study reviewed patients with AC who underwent cLC between January 2010 and December 2020. cLC was d...

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Autores principales: Lee, Seung Jae, Choi, In Seok, Moon, Ju Ik, Yoon, Dae Sung, Choi, Won Jun, Lee, Sang Eok, Sung, Nak Song, Kwon, Seong Uk, Bae, In Eui, Roh, Seung Jae, Kim, Sung Gon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Endo-Laparoscopic & Robotic Surgery 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218398/
https://www.ncbi.nlm.nih.gov/pubmed/35821685
http://dx.doi.org/10.7602/jmis.2022.25.2.63
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author Lee, Seung Jae
Choi, In Seok
Moon, Ju Ik
Yoon, Dae Sung
Choi, Won Jun
Lee, Sang Eok
Sung, Nak Song
Kwon, Seong Uk
Bae, In Eui
Roh, Seung Jae
Kim, Sung Gon
author_facet Lee, Seung Jae
Choi, In Seok
Moon, Ju Ik
Yoon, Dae Sung
Choi, Won Jun
Lee, Sang Eok
Sung, Nak Song
Kwon, Seong Uk
Bae, In Eui
Roh, Seung Jae
Kim, Sung Gon
author_sort Lee, Seung Jae
collection PubMed
description PURPOSE: This study was performed to investigate the effect of drain placement on complicated laparoscopic cholecystectomy (cLC) for acute cholecystitis (AC). METHODS: This single-center retrospective study reviewed patients with AC who underwent cLC between January 2010 and December 2020. cLC was defined as open conversion, subtotal cholecystectomy, adjacent organ injury during surgery, operation time of ≥90 minutes, or estimated blood loss of ≥100 mL. One-to-one propensity score matching was performed to compare the surgical outcomes between patients with and without drain on cLC. RESULTS: A total of 216 patients (mean age, 65.8 years; 75 female patients [34.7%]) underwent cLC, and 126 (58.3%) underwent intraoperative abdominal drainage. In the propensity score-matched cohort (61 patients in each group), early drain removal (≤postoperative day 3) was performed in 42 patients (68.9%). The overall rate of surgical site infection (SSI) was 10.7%. Late drain removal demonstrated significantly worse surgical outcomes than no drain placement and early drain removal for overall complications (13.1% vs. 21.4% vs. 47.4%, p = 0.006), postoperative hospital stay (3.8 days vs. 4.4 days vs. 12.7 days, p < 0.001), and SSI (4.9% vs. 11.9% vs. 31.6%, p = 0.006). In the multivariate analysis, late drain removal was the most significant risk factor for organ space SSI. CONCLUSION: This study demonstrated that drain placement is not routinely recommended, even after cLC for AC. When placing a drain, early drain removal is recommended because late drain removal is associated with a higher risk of organ space SSI.
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spelling pubmed-92183982022-07-11 Optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study Lee, Seung Jae Choi, In Seok Moon, Ju Ik Yoon, Dae Sung Choi, Won Jun Lee, Sang Eok Sung, Nak Song Kwon, Seong Uk Bae, In Eui Roh, Seung Jae Kim, Sung Gon J Minim Invasive Surg Original Article PURPOSE: This study was performed to investigate the effect of drain placement on complicated laparoscopic cholecystectomy (cLC) for acute cholecystitis (AC). METHODS: This single-center retrospective study reviewed patients with AC who underwent cLC between January 2010 and December 2020. cLC was defined as open conversion, subtotal cholecystectomy, adjacent organ injury during surgery, operation time of ≥90 minutes, or estimated blood loss of ≥100 mL. One-to-one propensity score matching was performed to compare the surgical outcomes between patients with and without drain on cLC. RESULTS: A total of 216 patients (mean age, 65.8 years; 75 female patients [34.7%]) underwent cLC, and 126 (58.3%) underwent intraoperative abdominal drainage. In the propensity score-matched cohort (61 patients in each group), early drain removal (≤postoperative day 3) was performed in 42 patients (68.9%). The overall rate of surgical site infection (SSI) was 10.7%. Late drain removal demonstrated significantly worse surgical outcomes than no drain placement and early drain removal for overall complications (13.1% vs. 21.4% vs. 47.4%, p = 0.006), postoperative hospital stay (3.8 days vs. 4.4 days vs. 12.7 days, p < 0.001), and SSI (4.9% vs. 11.9% vs. 31.6%, p = 0.006). In the multivariate analysis, late drain removal was the most significant risk factor for organ space SSI. CONCLUSION: This study demonstrated that drain placement is not routinely recommended, even after cLC for AC. When placing a drain, early drain removal is recommended because late drain removal is associated with a higher risk of organ space SSI. The Korean Society of Endo-Laparoscopic & Robotic Surgery 2022-06-15 2022-06-15 /pmc/articles/PMC9218398/ /pubmed/35821685 http://dx.doi.org/10.7602/jmis.2022.25.2.63 Text en Copyright © 2022 The Korean Society of Endo-Laparoscopic & Robotic Surgery. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Lee, Seung Jae
Choi, In Seok
Moon, Ju Ik
Yoon, Dae Sung
Choi, Won Jun
Lee, Sang Eok
Sung, Nak Song
Kwon, Seong Uk
Bae, In Eui
Roh, Seung Jae
Kim, Sung Gon
Optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study
title Optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study
title_full Optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study
title_fullStr Optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study
title_full_unstemmed Optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study
title_short Optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study
title_sort optimal drain management following complicated laparoscopic cholecystectomy for acute cholecystitis: a propensity-matched comparative study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9218398/
https://www.ncbi.nlm.nih.gov/pubmed/35821685
http://dx.doi.org/10.7602/jmis.2022.25.2.63
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