Routine Abdominal Drain Not Recommended After Laparoscopic Appendectomy for Perforated Appendicitis: Study

Researchers have found in a new study published in BMC Surgery by Hao Lu, Shikuan Li, Dawei Zhang, Shengqiang Wang, Hairui Liu, Chengzhi Wang, and Honghao Peng that there was no clear advantage to routine abdominal drain placement in adults undergoing laparoscopic appendectomy for perforated appendicitis. The authors report that across matched patient groups, use of a drain was associated with longer operative time, extended antibiotic courses, and longer hospital stay, but did not reduce surgical site infection rates. Their findings support current guideline trends that discourage routine drainage, while noting that further multicenter randomized controlled trials are needed for definitive confirmation.

The investigators retrospectively reviewed clinical data from adult patients treated between 2019 and 2024 at Qingdao University’s affiliated hospital, distinguishing those who received an abdominal drain during surgery from those who did not.

They applied propensity score matching to balance baseline characteristics and reduce confounding. After matching, both groups showed similar rates of surgical site infection, indicating no statistically significant benefit from drainage in preventing postoperative infection. On the flip side, the drain group demonstrated longer durations of postoperative antibiotic use, longer hospital stays, and greater operative time. The odds ratio for surgical site infection in drain versus non-drain groups was essentially neutral.