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.
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.
Study Type
OBSERVATIONAL
Enrollment
559
We want to put a assess the predictive factors for prophylactic drain after cholecystectomy.
Safeer Al-Husain Hospital
Karbala, Iraq
Proportion of patients undergoing laparoscopic cholecystectomy who require intraoperative drain insertion
Time frame: Immediately post-op, day zero
Operative time
Duration of laparoscopic cholecystectomy measured in minutes, from first incision to closure
Time frame: Day 0 (intraoperative period)
Incidence of intraoperative bile or stone spillage
Documented occurrence of bile leakage or gallstone spillage during the procedure.
Time frame: Day 0 (intraoperative period)
Gallbladder wall thickness
Preoperative ultrasound measurement of gallbladder wall thickness and its association with drain placement.
Time frame: Baseline (preoperative imaging)
Presence of adhesions
Intraoperative finding of pericholecystic or omental adhesions
Time frame: Day 0 (intraoperative period)
Patient demographics
Age, Gender (male/female), Body Mass Index,
Time frame: Baseline (before surgery)
Clinical presentation
Acute inflammation, chronic inflammation, biliary colic, acute on chronic inflammation
Time frame: Baseline (preoperative assessment)
Trocar insertion technique
Easy blind, difficult blind, easy open, difficult open, or Veress needle.
Time frame: Intraoperative
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Gallbladder anatomy
Classical, adhesions, anomaly
Time frame: Intraoperative
Common bile duct anatomy
Time frame: Intraoperative
Number of clips used
Time frame: Intraoperative
Hepatic bed status
None, oozing, active bleeding
Time frame: Intraoperative
Gallbladder extraction technique
Without manipulation, evacuation of content, wound extension, extension + evacuation, endobag
Time frame: Intraoperative
Other adverse events
Time frame: Intraoperative