ROLE OF DRAIN PLACEMENT AFTER LAPAROSCOPIC CHOLECYSTECTOMY: A PROSPECTIVE COMPARATIVE STUDY

Background: Laparoscopic cholecystectomy (LC) is the standard surgical treatment for symptomatic gallstone disease. However, the routine use of postoperative subhepatic drains remains controversial. Although drains are traditionally used to detect or evacuate postoperative bleeding and bile leakage, they may increase postoperative discomfort and prolong hospitalization. Objective: To compare postoperative outcomes between patients undergoing laparoscopic cholecystectomy with and without postoperative drain placement, with particular emphasis on postoperative pain, operative duration, postoperative complications, and length of hospital stay. Methods: This prospective comparative observational study was conducted in the Department of General Surgery, MVAS Medical College, Basti, over one year (2025–2026). A total of 100 patients undergoing laparoscopic cholecystectomy were included, with 50 patients managed with postoperative subhepatic drainage and 50 without drainage. Demographic characteristics, intraoperative findings, postoperative pain assessed using the Visual Analog Scale (VAS) at 6, 24, and 48 hours, postoperative complications, and duration of hospital stay were evaluated. Continuous and categorical variables were compared using appropriate statistical tests, with p<0.05 considered statistically significant. Results: The mean operative duration was significantly longer in the drain group than in the no-drain group (61.5 ± 12.1 vs. 55.7 ± 10.4 minutes; p=0.012). Postoperative pain was significantly higher in the drain group at 6 hours (5.8 ± 1.3 vs. 5.1 ± 1.2; p=0.006), 24 hours (4.7 ± 1.2 vs. 3.4 ± 1.1; p<0.001), and 48 hours (3.2 ± 1.0 vs. 2.2 ± 0.9; p<0.001). The overall postoperative complication rate was higher in the drain group (32.0% vs. 18.0%), although the difference was not statistically significant (p=0.106). Mean hospital stay was significantly longer among patients with drains (2.3 ± 0.8 vs. 1.8 ± 0.6 days; p<0.001). No significant differences were observed in subhepatic collection, bile leak, wound infection, nausea/vomiting, or readmission. Conclusion: In this comparative study, postoperative drain placement following laparoscopic cholecystectomy was associated with increased postoperative pain, longer operative duration, and prolonged hospital stay, without a significant reduction in postoperative complications. Selective rather than routine drain placement may therefore be preferable when guided by specific intraoperative findings.