Closed-suction versus Penrose drainage after cholecystectomy. A prospective, randomized evaluation

Closed-suction drainage was compared prospectively to open, passive drainage (Penrose drains) in 128 patients undergoing cholecystectomy. Patients were randomized at the time of operation to receive either closed-suction drains (Group I, 67 patients) or Penrose drains (Group II, 61 patients). The preoperative clinical parameters of the two groups were similar. The patients in Group I when compared with those in Group II had a shorter duration of drainage (3.3 days and 4.1 days, respectively, p < 0.01), a lesser volume of drainage in the first 48 hours postoperatively (78 ml and 132 ml, respectively, p < 0.001), a decreased incidence of fever on the night of operation (24 of 67 patients and 39 of 61 patients, respectively, p < 0.05) and on the first postoperative day (26 of 67 patients and 32 of 61 patients, respectively, p < 0.05), and a lower leukocyte count on the first postoperative day (12,000 cells/mm³ and 14,100 cells/mm³, respectively, 0.05 < p < 0.1). Patients in Group I tended to have a lower rate of wound infection (1 of 67 patients versus 5 of 61 patients in Group II, 0.05 < p < 0.1) and had a much lower incidence of drain site tenderness (8 of 67 patients in Group I versus 24 of 61 patients in Group II, p < 0.05). This study demonstrates the superiority of closed-suction drains over open, passive drains after cholecystectomy.