Cholecystitis
Conditions
Keywords
Laproscopic cholecystectomy, Drain, Predictive factors
Brief summary
This study looks at when surgical drains are truly needed after laparoscopic gallbladder removal (laparoscopic cholecystectomy). Drains are sometimes placed during surgery to prevent fluid buildup or infection, but many studies show they are not always necessary. We reviewed 559 patients who had this surgery at Safeer Al-Husain Hospital in Karbala, Iraq. The goal of this study is to help doctors decide more carefully when to use drains, so patients can avoid unnecessary tubes and recover more quickly.
Detailed description
Background: Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic gallstones, offering benefits such as reduced pain, shorter hospital stays, and faster recovery. However, postoperative complications like bile leakage, hemorrhage, and infection remain concerns. Many surgeons use intraoperative drains routinely to prevent these complications, though evidence increasingly suggests selective use may be preferable. Few studies have systematically identified which patient or intraoperative factors predict the need for drain placement. Objective: To identify demographic, clinical, and intraoperative predictors of surgical drain placement after LC, enabling evidence-based, selective drain use. Methods: * Design: prospective cross-sectional study at Safeer Al-Husain Hospital, Karbala, Iraq. * Population: 559 patients undergoing LC. * Data Collection: Patient demographics, operative details, intraoperative findings, and drain usage were extracted from standardized hospital records. * Statistical Analysis: Associations between patient/surgical variables and drain placement were assessed using univariate and multivariate logistic regression. Statistical significance was defined as p \< 0.05.
Interventions
OTHERDrain
We want to put a assess the predictive factors for prophylactic drain after cholecystectomy.
Sponsors
University of Baghdad
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* Underwent laparoscopic cholecystectomy (LC) at Safeer Al-Husain Hospital, Karbala, Iraq. * Both male and female patients. * Diagnosed with gallstone disease, including: * Chronic cholecystitis * Acute cholecystitis * Acute-on-chronic cholecystitis * Biliary colic
Exclusion criteria
* Conversion from laparoscopic to open cholecystectomy prior to completion of the procedure. * Patients undergoing emergency surgery for gallbladder perforation with generalized peritonitis, where standard laparoscopic cholecystectomy was not feasible.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of patients undergoing laparoscopic cholecystectomy who require intraoperative drain insertion | Immediately post-op, day zero |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of intraoperative bile or stone spillage | Day 0 (intraoperative period) | Documented occurrence of bile leakage or gallstone spillage during the procedure. |
| Gallbladder wall thickness | Baseline (preoperative imaging) | Preoperative ultrasound measurement of gallbladder wall thickness and its association with drain placement. |
| Presence of adhesions | Day 0 (intraoperative period) | Intraoperative finding of pericholecystic or omental adhesions |
| Patient demographics | Baseline (before surgery) | Age, Gender (male/female), Body Mass Index, |
| Clinical presentation | Baseline (preoperative assessment) | Acute inflammation, chronic inflammation, biliary colic, acute on chronic inflammation |
| Trocar insertion technique | Intraoperative | Easy blind, difficult blind, easy open, difficult open, or Veress needle. |
| Operative time | Day 0 (intraoperative period) | Duration of laparoscopic cholecystectomy measured in minutes, from first incision to closure |
| Common bile duct anatomy | Intraoperative | — |
| Number of clips used | Intraoperative | — |
| Hepatic bed status | Intraoperative | None, oozing, active bleeding |
| Gallbladder extraction technique | Intraoperative | Without manipulation, evacuation of content, wound extension, extension + evacuation, endobag |
| Other adverse events | Intraoperative | — |
| Gallbladder anatomy | Intraoperative | Classical, adhesions, anomaly |
Countries
Iraq
Outcome results
None listed