Comparison of Abdominal Drainage and No-drainage after Elective Hepatectomy: A Randomized Study.

Background/aims: Recent clinical trials suggested that abdominal drainage is not needed in all cases and should be restricted in patients with chronic liver disease or patients who underwent minor liver resection. In this study we conducted a randomized study to determine whether abdominal drainage is beneficial or rather hazardous after hepatic resection.

Methodology: Two hundred consecutive patients undergoing elective hepatectomy were entered for this prospective, randomized, case-controlled study. Liver resection was performed under intermittent Pringle maneuver. Clinical data such as postoperative complications and mortality rates were evaluated as well as intraoperative parameters.

Results: There were no significant differences in postoperative morbidity between with and without abdominal drainage groups 16 vs. 12%). However, complications directly related no drainage such as drain site bleeding and infection, abdominal abscess, bile fistula, and ascites (CDRD) tended to be higher in the drainage group than the no-drainage group (9 vs. 3%, p = 0.067). Particularly, there was high incidence of CDRD in the drainage group compared with the no drainage group in patients with chronic liver diseases (13.2 vs. 1.8%, p = 0.027).

Conclusions: We do not recommend systematic drainage after elective hepatectomy, irrespective of the extent of resection and of the underlying liver diseases when the surgical procedure has been satisfactory.