520 The role of abdominal drains in Laparoscopic Appendicectomy: a prospective study of 260 patients
Grace Hume, Charlotte Burford, Ankur Shah- Surgery
Abstract
Aims
Guidance regarding the use of antibiotics and drains following laparoscopic appendicectomy remains unclear. We aim to describe current practice at our unit with the view to forming a local guideline.
Method
A prospective review of all adult patients undergoing laparoscopic appendicectomy at our unit between July 2021-July 2022 was performed. Data was collected from electronic patient records and theatre software, including patient demographics, blood and imaging results and drain and antibiotic details where applicable.
Results
260 patients underwent laparoscopic appendicectomy (53.1% female) with a median age of 38 years (IQR 30.75). 87.7% were positive for appendicitis on histology.11.2% were discharged within 23 hours from admission. The median length of stay was 2 days (IQR 2). 70.7% received postoperative antibiotics with a median duration of 5 days. 25.4% had a drain inserted and had a significantly longer inpatient stay (3 vs 2 days, p<0.001). Those with drains had a higher median CRP compared to those who did not (137 vs 38, p=<0.001) and this association remained significant on multivariate analysis when controlling for white blood cell count and lactate (p<0.001). Patients who had post-operative antibiotics or a drain were not more likely to re-present following discharge (p=0.586 and p=0.169 respectively).
Conclusions
In our cohort drains did not reduce likelihood of complications but increased length of time in hospital. Further research is needed to identify specific patients, if any, who would benefit from drain use.