ReviewAbdominal drainage versus no abdominal drainage for laparoscopic cholecystectomy: A systematic review with meta-analysis and trial sequential analysis

- This study has shown that routine drainage does not reduce the incidence of intra-abdominal fluid.
- There was no difference in the length of hospital stay. But drain use may increase resource utilization.
- Our study addresses a question that is relevant to the Enhanced Recovery After Surgery (ERAS) amongst the general surgeons.

The aim is to assess the benefits and harms of routine abdominal drainage in laparoscopic cholecystectomy.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, and Science Citation Index Expanded until August 2016.We included all randomised clinical trials comparing drainage versus no drainage after laparoscopic cholecystectomy irrespective of language and publication status.We used standard methodological procedures in accordance with the PRISMA guidelines.A total of 2398 participants were randomised to drain (1197 participants) versus 'no drain' (1201 participants) in 16 trials included in this article.Pain 24 h after surgery was less severe in the no drain group (MD1.31; 95% CI, 0.96 to 1.65; p < 0.00001).Abdominal drainage prolonged operative time (MD 5.77 min; 95% CI 4.98 min-6.57 min; p < 0.00001) but not the length of hospital stay (MD 0.21 days; 95% CI -0.00 days to 0.42 days; p = 0.05).No significant difference was present with respect to the intra-abdominal fluid, wound infection, nausea or vomit, mortality after operation.There is no significant advantage of drain placement after laparoscopic cholecystectomy. Further well designed randomized clinical trials should be carefully re-considered.