Clinical efficacy of combined subhepatic space drainage during laparoscopic cholecystectomy in patients with gangrenous cholecystitis

Background. Gangrenous cholecystitis, especially when complicated by perivesical inflammatory changes, is associated with a high risk of postoperative complications such as seromas and subhepatic abscesses. The relevance of the task determines the need to optimize drainage methods at the final stage of laparoscopic cholecystectomy (LC). Objective. To evaluate the efficacy of combined subhepatic space drainage in preventing postoperative seromas and abscesses in patients with gangrenous cholecystitis. Material and methods. The results of 210 patients who underwent LC for acute obstructive gangrenous cholecystitis were analyzed. The main group (n=82) included patients who underwent combined drainage (Robinson and Penrose drains). The control group (n=128) consisted of patients with only a suction Penrose drain. Results. The use of combined drainage resulted in a significant reduction in postoperative complications: the overall rate was 8.5% versus 47.6% in the control group. In the main group, not a single case of seroma (0%) or subhepatic abscess (0%) was recorded, while in the comparison group these complications occurred in 21.9% and 9.4% of patients, respectively. The mean duration of hospitalization was also shorter in the main group (9.1±2.3 days vs. 12.4±3.4 days). Conclusion. The proposed method of combined subhepatic space drainage is superior to the conventional method in preventing seromas and abscesses, reduces the length of hospital stay, and can be recommended for routine use in the surgical treatment of gangrenous cholecystitis.