The effectiveness of routine drain placement in laparoscopic sleeve gastrectomy: Single–center results

INTRODUCTION: Routine drainage of the abdominal cavity has been widely accepted in the diagnosis and treatment of complications, but many studies have questioned the usefulness of drainage. In complications after laparoscopic sleeve gastrectomy (LSG), the value of routine drainage is unknown. To determine whether routine drainage is required after LSG, we aimed to compare clinical data and complications between groups.
METHODS: This study included a retrospective analysis of LSGs from January 2017 to November 2019. Groups were defined as (Group D) with and without a drain (Group U). Complication diagnosis was confirmed using computed tomography (CT) or endoscopy after suspicion. Clear fluid was administered at the 6th postoperative hour. Data included age, height, body weight, BMI, mean operative time, length of hospital stay, and complications. Data between groups were compared.
RESULTS: The mean age of 744 patients (female=570, male=174) was 38 years (18–63), and the mean preoperative BMI was 47.9 kg/m2 (40–76). The hospitalization time was 4.03 days (2–23), and the operations were performed at an average of 83 minutes (30–225). There were Group D=547, Group U=197 patients. The complication rate was 6.7%. Sixteen of the 17 patients who were on the run were in group D and one in Group U. In Group D, 14 of the leaks were treated with stents, and 15 of them were treated with a percutaneous catheter, while in Group U, only one patient was treated using stents. The decrease in hemoglobin value was 3.07 g/dl on average, and bleeding was detected in 33 patients (Group D=22, Group U=11). Percutaneous catheter was applied to five patients in Group D.
DISCUSSION AND CONCLUSION: Routine drainage is not required after LSG. Neglected drainage can contribute to faster recovery, shortened hospital stay, and reduced cost without causing additional surgical complications.