Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Gallstone disease is the pathologic state of stones or calculi within the gallbladder lumen and biliary tree. This is a common digestive disorder worldwide, with occurrence varying from 6‐20%. The belief that surgical drainages serve as an early warning of bile leakage, impending bile peritonitis or intra‐abdominal haemorrhage is nowadays in dispute. Thus, the lack of bile from a drain cannot be interpreted as indicating the absence of bile leakage or the absence of impending bile peritonitis. The present prospective study entitled “Comparative study between drain versus no drain in elective cholecystectomy” is to be conducted on 200 patients admitted for elective Cholecystectomy in the department of surgery, J.A. Group of hospitals and G.R. Medical College, Gwalior (Madhya Pradesh) during 2015‐2016 after getting written informed consent from the patients. The main aim is ‘’To compare post operative pain and hospital stay elective cholecystectomy with or without drain’’. 200 patients who diagnosed as a case of cholelithiasis, admitted and giving consent for Cholecystectomy will be included in the study. Gallstone with any other associated intraoperative finding like ascites, tuberculosis, suspected mass, Gall bladder carcinoma with gall stones, Cholelithiasis with intraoperative suspicion of choledocholithiasis, Incidental cholecystectomies with other procedures these are excluded. Patients in drain group had more pain compared to without drain group. VAS median grade in without drain group was highest in G2 (48%) and VAS median grade in patients with drain group was highest in G4 (48%). Patients had more pain after open cholecystectomy (OC) as compare to laparoscopic Cholecystectomy. Wound infection was noted in 14 (7%) patients in the drain group and 2 (1%) patients without drain group in elective cholecystectomy. Wound infection was noted in 15 (15.78%) in open cholecystectomy (OC) and 1 (0.95%) in laparoscopic cholecystectomy. Mean subhepatic collection noted in patients with drain on1st day was 26.3+/‐12.7 mL and on 3rd day was 37.85+/‐12.65 mL and on 7th day was 22.83+/‐9.88 mL. Mean subhepatic collection in patients without drain on 1st day was 20+/‐7.84 mL and on 3rd day was 24+/‐9.34 mL and on 7th day 15.35+/‐7.48 mL. None of the patients required any intervention and were managed conservatively. Majority of patients in drain group had more subhepatic collection when compared to without drain group. Mean hospital stay in patients with drain was 8.38 +/‐1.86 days and patients without drain was 4.68+/‐1.25 days. Majority of patients with drain group stayed longer time period compared to drain group. Hospital stays also increase after open cholecystectomy (OC) as compare to laparoscopic cholecystectomy. Patients in “without drain” group have noted lesser post operative pain, lesser subhepatic collection and shorter hospital stay and less wound infection in elective Cholecystectomy compare to “with drain” group. There is more wound infection noted in open cholecystectomy (OC) as compare to laparoscopic Cholecystectomy. There is no significant difference as far as post operative wound infection in elective laparoscopic Cholecystectomy with drain or without drain.
How to cite this article:
Rakesh Darbar, Vikram Singh Mujalde, Pramod Pandey and Ravi Pratap Singh. Compare Post Operative Pain and Hospital Stay Elective Cholecystectomy with or Without Drain.
DOI: https://doi.org/10.36478/10.59218\makrjms.2023.492.497
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218\makrjms.2023.492.497