Drainage After Laparoscopic Appendectomy: What to Expect

Acute Appendicitis - Drainage Tube

Hello doctor, I was diagnosed with acute appendicitis on March 16 and underwent laparoscopic surgery the same day, which involved three incisions.
A drainage tube was placed in a hole 10 cm below my abdomen.
I was discharged on March 20.
Since the drainage tube was still producing about 230 cc daily, I was instructed to take it home and return for a follow-up in three days.
During the follow-up on March 23, the drainage output was about 110 cc daily and appeared light red.
The doctor advised me to return in a week to assess whether the tube could be removed.
On March 30, the output was 50-60 cc and appeared tea-colored with no odor.
However, after the tenth day, my abdominal fluid output has remained between 50-60 cc with almost no decrease.
Is this normal?

Harper, 30~39 year old female. Ask Date: 2023/04/01

Dr. Chen Jiaming reply Surgery

There is no standard value for the total amount of ascites produced after abdominal surgery in each patient, as it is related to the extent of the peritoneal and intestinal surface exposure during the procedure.
Additionally, individual body tissue hydration and permeability also play a role.
Therefore, when encountering significant amounts of ascites, the focus is primarily on whether the volume is gradually decreasing (indicating internal healing) and the characteristics of the drained fluid, such as its color and consistency.
Based on your description, it seems that there shouldn't be any major concerns, so there's no need to worry!

Reply Date: 2023/04/01

More Info

After undergoing a laparoscopic appendectomy, it is common for patients to have concerns regarding drainage, especially when a drain is placed post-operatively. In your case, the drainage from the site of the surgery is being monitored closely, and it is essential to understand what is considered normal and what might indicate a need for further evaluation.

Understanding Post-Operative Drainage
1. Normal Drainage Patterns: After surgery, it is typical for the drainage to be initially higher, especially if there was significant inflammation or fluid accumulation during the procedure. The fact that your drainage started at 230cc and gradually decreased to 50-60cc is a positive sign, indicating that the body is beginning to heal and resolve any fluid accumulation.
2. Color and Consistency: The color of the drainage can provide insight into the healing process. Initially, a reddish hue is expected due to the presence of blood; however, as healing progresses, the drainage should transition to a clearer or tea-colored fluid, which is a sign of serous fluid. The absence of foul odor is also a good indicator that there is no infection.

3. Duration of Drainage: It is not uncommon for drainage to persist for a period after surgery, especially if there was significant fluid accumulation or if the body is still resolving inflammation. The fact that your drainage has stabilized at 50-60cc for several days is not necessarily alarming, but it does warrant continued monitoring.

When to Seek Further Evaluation
1. Persistent Drainage: If the drainage remains consistently at 50-60cc for an extended period without signs of improvement, it may be worth discussing with your surgeon. They may consider imaging studies or further evaluation to ensure there are no underlying issues, such as a fluid collection or abscess.

2. Signs of Infection: While your drainage does not have an odor, it is essential to monitor for other signs of infection, such as increased redness, swelling at the drain site, fever, or worsening pain. If any of these symptoms occur, it is crucial to contact your healthcare provider immediately.

3. Follow-Up Appointments: It is vital to adhere to the follow-up schedule provided by your surgeon. They will assess the drainage, the surgical site, and your overall recovery during these visits. If your surgeon recommends keeping the drain in place longer, it is typically for your safety and to ensure proper healing.

Conclusion
In summary, while it is normal for drainage to persist after a laparoscopic appendectomy, the key factors to monitor include the volume, color, and any associated symptoms. Your current drainage pattern appears to be within a reasonable range, but continued observation is essential. If you have any concerns or if the drainage does not decrease further, do not hesitate to reach out to your healthcare provider for advice. They can provide the best guidance based on your specific situation and ensure that your recovery continues smoothly.

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