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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...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Society of Endo-Laparoscopic & Robotic Surgery
2022
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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. |
format | Online Article Text |
id | pubmed-9218398 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Korean Society of Endo-Laparoscopic & Robotic Surgery |
record_format | MEDLINE/PubMed |
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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