Clinical significance of drainage tube insertion in laparoscopic cholecystectomy: a prospective randomized controlled trial

Background/Purpose We aimed to investigate the appropriateness of inserting an intraperitoneal drainage tube after laparoscopic cholecystectomy (LC), based on postoperative pain and clinical courses, in a randomized comparative study. Methods One hundred and twenty patients who were to have LC were enrolled in this prospective randomized study. An 8‐mm Penrose drain was retained below the liver bed for 42 h in each of 60 patients (group A), and no drain was retained in the remaining 60 patients (group B). Patients in each group were hospitalized for 4 days after operation, and the pain reported by the patients, using a visual analogue pain scale (VAS), and the time courses of changes in the highest body temperature, leukocyte count, and C‐reactive protein (CRP) were studied comparatively for men and women. Results Mean VAS scores were significantly greater in group A than in group B at 24 h (P = 0.00004), and 48 h (P = 0.0014) after operation. When sex‐stratified changes in mean VAS scores were compared within group A, females had more pain than their male counterparts at 24 h (P = 0.030), but group B showed no sex differences. When the number of patients who used analgesics postoperatively was compared between groups A and B, analgesics were used more frequently in group A. When changes in maximum body temperature were compared, the change was significantly higher in group A than in group B on day 2 after the operation (P = 0.017). Conclusions Postoperative pain was intensified by the insertion of a drainage tube after LC. This tendency was stronger in women.