Antibiotic prophylaxis for patients undergoing elective laparoscopic cholecystectomy

Sanábria, Álvaro; Valdivieso, Eduardo; Gómez, Gabriel; Domínguez, Luis Carlos

doi:10.1002/14651858.cd005265

Cited by 24 publications

(35 citation statements)

References 20 publications

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“…In our study, postoperative antibiotic usage was not significantly different between the two groups (p=0.201). In a review of 11 clinical trials, Sanabria et al (41) found no significant difference regarding surgical site infection and antibiotic use. In our study, surgical site infection was not encountered in the LPC group while it occurred in 5 CC patients.…”

mentioning

confidence: 99%

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Kulen¹,

Tıhan²,

Duman³

et al. 2016

UCD

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Objective: Laparoscopic cholecystectomy has become the ''gold standard'' for benign gallbladder diseases due to its advantages. In the presence of inflammation or fibrosis, the risk of bleeding and bile duct injury is increased during dissection. Laparoscopic partial cholecystectomy (LPC) is a feasible and safe method to prevent bile duct injuries and decrease the conversion (to open cholecystectomy) rates in difficult cholecystectomies where anatomical structures could not be demonstrated clearly. Material and Methods:The feasibility, efficiency, and safety of LPC were investigated. The data of 80 patients with cholelithiasis who underwent LPC (n=40) and conversion cholecystectomy (CC) (n=40) were retrospectively examined. Demographic characteristics, ASA scores, operating time, drain usage, requirement for intensive care, postoperative length of hospital stay, surgical site infection, antibiotic requirement and complication rates were compared. Results:The median ASA value was 1 in the CC group and 2 in the LPC group. Mean operation time was 123 minutes in the CC group, and 87.50 minutes in the LPC group. Surgical drains were used in 16 CC patients and 4 LPC patients. There was no significant difference between groups in postoperative length of intensive care unit stay (p=0.241). When surgical site infections were compared, the difference was at the limit of statistical significance (p=0.055). Early complication rates were not different (p=0.608) but none of the patients in the LPC group suffered from late complications. Conclusion:LPC is an efficient and safe way to decrease the conversion rate. LPC seems to be an alternative procedure to CC with advantages of shorter operating time, lower rates of surgical site infection, shorter postoperative hospitalization and fewer complications in high-risk patients.

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mentioning

confidence: 99%

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Kulen¹,

Tıhan²,

Duman³

et al. 2016

UCD

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“…(30) These guidelines are based, in part, on previous systematic reviews. [31][32][33][34] In addition, there is a global campaign that aims to reduce inappropriate antibiotic administration to tackle the issue of emerging microbial resistance and other problems, such as increasing rates of Clostridium difficile infection. 35,36 Despite this guidance and initiatives, between 20 and 80 percent of patients undergoing cholecystectomy with a low and moderate risk of SSI are still given antibiotics in nationally collected data sets.…”

Section: Discussionmentioning

confidence: 99%

The Role of Prophylactic Antibiotics in Patients Undergoing Elective Cholecystectomy- A Randomised Placebo Controlled Recipient Blind Trial

Basu¹,

Sarkar²,

Chaudhury³

et al. 2017

jemds

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BACKGROUNDLaparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis. The incidence of infectious complications after LC is significantly lower compared with infections with open cholecystectomy. 1,2 Antibiotic prophylaxis may not be necessary in low-risk patients undergoing elective LC. 6-10 On the contrary, many other surgeons still use and recommend the administration of prophylactic antibiotics. [11][12][13][14][15] The aim of this study is to determine the necessity of prophylactic antibiotics in preventing the postoperative infective complications in patients undergoing elective laparoscopic cholecystectomy.

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“…For example, a Cochrane review looking at laparoscopic cholecystectomy observed no statistically significant differences between antibiotic prophylaxis and no prophylaxis in the proportion of surgical site or extra-abdominal infections [8]. The meta-analysis involved 11 RCTs with 1,664 patients in total (900 in the prophylaxis group and 764 in the noprophylaxis group).…”

Section: Discussionmentioning

confidence: 99%

“…Hysteroscopic surgery is also minimally invasive surgery performed via the cervical orifice. It is therefore thought that the risk of contamination in endoscopic surgery is much lower compared to open surgery and the use of antibiotics may not confer any additional benefit [8]. Endoscopic gynaecological surgeons practicing in the United Kingdom currently have no available national recommendations on which to base their practice in relation to antibiotic prophylaxis; hence, practice is likely to differ between various hospitals and individual surgeons.…”

Section: Introductionmentioning

confidence: 99%

Role of prophylactic antibiotics in endoscopic gynaecological surgery; a consensus proposal

2014

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Surgical site infection can result in increased morbidity for the patient, prolonged hospital stay and hospital readmission. Preoperative antibiotics reduce the incidence of such infections, particularly in open surgery. Universal use of antibiotic prophylaxis, however, is not recommended due to the risks of adverse reactions, generation of resistant bacteria and additional cost. Endoscopic procedures carry low risk of wound contamination and infection. Limited data suggest wide variability in antibiotic prophylaxis in gynaecological surgery and potential overuse of antibiotics in gynaecological endoscopic surgery. Bringing together the existing evidence allows for a consensus proposal for the use of preoperative antibiotics in gynaecological endoscopy.

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Antibiotic prophylaxis for patients undergoing elective laparoscopic cholecystectomy

Cited by 24 publications

References 20 publications

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

The Role of Prophylactic Antibiotics in Patients Undergoing Elective Cholecystectomy- A Randomised Placebo Controlled Recipient Blind Trial

Role of prophylactic antibiotics in endoscopic gynaecological surgery; a consensus proposal

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