Canadian journal of surgery. Journal canadien de chirurgie
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The authors studied the effect of intraoperative drainage, presence of postoperative pyrexia, influence of appendectomy, chest complications and wound infection in 200 patients who had undergone routine uncomplicated cholecystectomy. One hundred patients in whom no drain was inserted were matched with 100 patients whose cholecystectomies, performed during the same period, included placement of a drain. ⋯ The rate of wound infection was substantially increased in both groups by adding appendectomy to the procedure, particularly if drains were not used. It is evident that the routine placement of a drain in an uncomplicated cholecystectomy is unnecessary and may even be harmful.
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The authors report unusual complications arising from the ingestion of a small fish bone by a 68-year-old man. These included mediastinitis, empyema, pericarditis and septic shock, probably secondary to a small perforation of the esophagus. After appropriate surgical drainage, antibiotic therapy and supportive therapy the patient made a good recovery.