Cholecystectomy: safe or not safe to drain?

The aim of this study was to determine whether drains influenced the size of subhepatic collections following cholecystectomy, and if these had any affect on complications. Eighty-five patients undergoing cholecystectomy had either no drain, a narrow bore suction drain or an open corrugated drain. Subhepatic fluid collections were measured by real time ultrasound on the first and fifth postoperative days, and thereafter if necessary. The volumes of fluid drained were also measured and clinical complications recorded. The subhepatic collections were, on average, the same whether a drain was used or not. Drains produced volumes considerably in excess of any subhepatic collection measured, but they did not appear to warn of biliary leakage. More complications (28%) were seen in the drained group compared with the undrained group (10.5%), and furthermore, the complications did not seem to occur in relation to the larger collections. One patient who had had a corrugated drain correctly placed developed biliary peritonitis. We suggest that drainage of simple cholecystectomy is unnecessary and, if an open drain is used, potentially dangerous.