A Cochrane review [Abstract] 1 included 5 studies with a total of 465 subjects. 234 patients were randomised to the drain group and 231 to the no drain group. There was no statistically significant difference for any of the outcomes between the drain group and no drain group (mortality OR 1.17, 95% CI 0.37 to 3.70), re-operation (OR 1.35, 95% CI 0.44 to 4.11), infected intra-abdominal collections (OR 2.01, 95% CI 0.73 to 5.50) or wound infection (OR 1.78, 95% CI 0.87 to 3.64). There was also no statistically significant difference between the two groups in ascitic leak and hospital stay, when the random-effects model was adopted. One randomised clinical trial of low methodological quality comparing open with closed drainage (186 patients) showed a lower incidence of infected intra-abdominal collections, chest complications, and hospital stay in the closed drain group.
Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).
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