To the Editor.—The arguments for and against drainage in gallbladder surgery are articulated with such religious fervor that one must have no illusion that any one comment will sway the balance. I fully concur with Ross and Quinlan (Arch Surg 110:721, 1975) "that gallbladder surgery can be carried out without drainage in a large majority of patients with acceptable morbidity, mortality...."
Nevertheless, in the hospital in which I work (which is comparable in size, skill, the background of its surgeons, and the number of cholecystectomies performed), we have had four large bile collections in the last ten years in undrained patients who required secondary operations. The most important thing to note in these four cases is that the operations were elective and easily performed. The patients were thin or average subjects with chronic disease who experienced no appreciable bleeding or evident bile leakage during the original procedure. At the