Predictive Factors of Drain Insertion After Laparoscopic Cholecystectomy: A Cohort Study

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.

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.