Antibiotic Prophylaxis in Laparoscopic Cholecistectomy: Is It Worth Doing?

Abstract

Background: Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis Aim: Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Method: Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis. The outcome evaluated were infeccious complications at surgical site. The patients were reviewed seven and 30 days after surgery. Results: There was incidence of 2% in infection complications in group A and 2% in group B. There was no statistical significant difference of infectious complications (p=0,05) between the groups. The groups were homogeneous and comparable. Conclusion: The use of the antibiotic prophylaxis in laparoscopic cholecystectomy in low risk patients doesn't provide any significant benefit in the decrease of surgical wound infection.

Outcome of Laparoscopic Cholecystectomy in Patients With Gallstone Disease at a Secondary Level Care Hospital

“…Surgical site infection is significantly lower after laparoscopic surgery compared to open surgery and patients treated with laparoscopy were 72% less likely to experience an surgical site infection 11 , 17 . Were encountered 21 cases of wound infection (4.3%), which is consistent with the incidence in the literature.…”

“…The advantages of the laparoscopic approach are less postoperative pain, shorter hospital stay, faster recovery, improved cosmetic results, early return to work, fewer complications such as infection 11 , adhesions, short operating time and low learning curve 7 , 10 , 16 and, it is superior to other developed techniques because of economic advantage 10 .…”

Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study

“…The first laparoscopic cholecystectomy was performed in 1987 by Mouret. The surgeons are performing increasing number of laparoscopic cholecystectomies because of accompanying less postoperative pain, shorter hospital stay, faster recovery, improved cosmetic results, early return to work, fewer complications such as infection [3], adhesions, short operating time and low learning curve [4] and, it is superior to other developed techniques because of economic advantage [5]. The main risk associated with the laparoscopic cholecystectomy appears to be a higher incidence of bile duct injury than open cholecystectomy 0.3-0.8% [6].…”

Prevalence of Bacteriobilia in Patients Undergoing Elective Colecystectomy

“…It is estimated, nowadays, that 85% of the patients with cholecystolithiasis keep asymptomatic for at least 10 years. In the last two decades, the knowledge and management evolved in a meaningful way, and a lot of clinical and microbiological parameters have been studied, just like the way how antibiotics and defense systems of biliary tract interfere with the evolution of the infections in bile duct 1 , 4 , 10 , 11 .…”