Prophylactic abdominal drainage versus no drainage after laparoscopic appendectomy for perforated acute appendicitis: a multicenter propensity score-weighted analysis - Summary - MDSpire
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Comparison of Prophylactic Abdominal Drainage and Non-Drainage Following Laparoscopic Appendectomy for Perforated Acute Appendicitis: A Multicenter Propensity Score-Weighted Study

  • By

  • Tomohiro Akutsu

  • Akira Endo

  • Yoshiaki Inoue

  • Hazuki Koguchi

  • Hirotada Muramatsu

  • Shuji Saito

  • Satoshi Okumura

  • Chisato Yonekawa

  • Asuka Fukuo

  • Shuichi Kobori

  • Masakazu Wakabayashi

  • Kei Ito

  • Hiroyuki Kasajima

  • Atsushi Tabeta

  • Ryohei Kosaki

  • Seiichiro Yamamoto

  • Takeshi Nakamura

  • Komei Kuge

  • Ryo Yamamoto

  • Fumitoshi Mizutani

  • Yuko Okishio

  • Takeshi Yokoyama

  • Haruka Shimoda

  • Hiraaki Okuzawa

  • Yasukazu Narita

  • Hiromasa Hoshi

  • Keisuke Suzuki

  • Koji Ito

  • Yasuhiro Otomo

  • Koji Morishita

  • September 9, 2026

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Objective:

To evaluate the association of abdominal drainage with postoperative intra-abdominal abscess (IAA) formation following laparoscopic appendectomy for perforated acute appendicitis.

Approach:
  • Study Design: The DLAP study involved 21 institutions in Japan, utilizing a multicenter dataset with comprehensive clinical and intraoperative information.
  • Patient Selection: Patients undergoing laparoscopic appendectomy for perforated appendicitis from January 1, 2015, to December 31, 2023, were included, with drain placement determined by the surgeon's discretion.
  • Data Collection: Data were collected retrospectively from electronic medical records, including demographic characteristics, intraoperative findings, and postoperative outcomes.
  • Outcomes: The primary endpoint was IAA formation within 30 days postoperatively; secondary endpoints included Clavien–Dindo grade IIIa or higher abscesses, SSI, ileus, readmission, and hospitalization duration.
  • Statistical Analysis: Continuous variables were reported as medians and interquartile ranges; categorical variables as counts and percentages, using propensity score methods to adjust for baseline differences.
Key Findings:
  • Prophylactic drainage did not significantly reduce the incidence of intra-abdominal abscesses.
  • Drainage was associated with longer hospital stays and increased drain-related complications.
Interpretation:

The study suggests that routine use of prophylactic abdominal drainage in laparoscopic appendectomy for perforated appendicitis may not be beneficial.

Limitations:
  • The study was retrospective and lacked randomized treatment allocation.
  • Inclusion criteria did not require pathological confirmation of perforation.
Conclusion:

The findings indicate that prophylactic drainage may not be necessary in laparoscopic appendectomy for perforated appendicitis.

Original Source(s)

Prophylactic abdominal drainage versus no drainage after laparoscopic appendectomy for perforated acute appendicitis: a multicenter propensity score-weighted analysis

  • by Tomohiro Akutsu, Akira Endo, Yoshiaki Inoue, Hazuki Koguchi, Hirotada Muramatsu, Shuji Saito, Satoshi Okumura, Chisato Yonekawa, Asuka Fukuo, Shuichi Kobori, Masakazu Wakabayashi, Kei Ito, Hiroyuki Kasajima, Atsushi Tabeta, Ryohei Kosaki, Seiichiro Yamamoto, Takeshi Nakamura, Komei Kuge, Ryo Yamamoto, Fumitoshi Mizutani, Yuko Okishio, Takeshi Yokoyama, Haruka Shimoda, Hiraaki Okuzawa, Yasukazu Narita, Hiromasa Hoshi, Keisuke Suzuki, Koji Ito, Yasuhiro Otomo, Koji Morishita

  • September 9, 2026

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