Extended Postoperative Antibiotics Versus No Postoperative Antibiotics in Patients Undergoing Emergency Cholecystectomy for Acute Calculous Cholecystitis: A Systematic Review and Meta-Analysis

Hajibandeh, Shahab; Popova, Petya; Rehman, Sheik

doi:10.1177/1553350619835347

Cited by 11 publications

(8 citation statements)

References 21 publications

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“…2 Several studies reported that postoperative antibiotic use did not improve infectious or noninfectious complications in AC patients who underwent emergency LC and postoperative antibiotics should not be routinely used. [11][12][13] The authors argued that the main purpose of postoperative antibiotics in AC is to prevent systemic inflammation by translocation of bactibilia into the systemic circulatory system. The prevalence of positive bile culture was not found to be related to the severity of AC, 14,15 and it has also been shown that antibiotic treatment for AC in patients with documented bactibilia does not always prevent local or systemic complications.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies reported that postoperative antibiotic use did not improve infectious or noninfectious complications in AC patients who underwent emergency LC and postoperative antibiotics should not be routinely used 11–13 . The authors argued that the main purpose of postoperative antibiotics in AC is to prevent systemic inflammation by translocation of bactibilia into the systemic circulatory system.…”

Section: Discussionmentioning

confidence: 99%

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Clinical significance of preoperative antibiotic use in mild to moderate acute inflammatory gallbladder disease: A randomized controlled trial

Park

Choi

You

et al. 2022

J Hepato Biliary Pancreat

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Background: Many patients receive empirical antibiotics for the prevention of postoperative infectious complications following cholecystectomy due to acute cholecystitis (AC). The purpose of this study was to investigate the clinical significance of preoperative antibiotics in mild to moderate AC patients undergoing emergency laparoscopic cholecystectomy.Methods: This was a double-blind, placebo-controlled, randomized study.Patients with AC eligible for emergency laparoscopic cholecystectomy were randomly assigned to an antibiotic or a placebo group. Clinical outcomes including infectious complications were reviewed.Results: An imputed per-protocol analysis of 234 patients showed that the postoperative infection rate was 8.6% (10 of 116 patients) in the antibiotic group and 7.6% (9 of 118 patients) in the placebo group (absolute difference, 1%; 95% CI: −8.1% to 6.1%; P = .815). Based on a noninferiority margin of 10%, the lack of preoperative antibiotic treatment was not associated with worse clinical outcomes than antibiotic treatment. Surgical site infection was the most common complication among the infectious complications, and there was no significant difference between the two groups (7.8% in the antibiotic group vs 7.6%, in the placebo group, P = .53). Conclusions:The absence of prophylactic antibiotics has no significant impact on the incidence of infectious complications in mild to moderated AC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical significance of preoperative antibiotic use in mild to moderate acute inflammatory gallbladder disease: A randomized controlled trial

Park

Choi

You

et al. 2022

J Hepato Biliary Pancreat

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“…Many studies have been published on antibiotic prophylaxis in acute cholecystitis, but the results of these analyses are often contradictory due to the assessment of heterogeneous groups of patients [ 170 ]. In a systematic review of randomized studies, van Dijk et al .…”

Section: Acute Cholecystitismentioning

confidence: 99%

The Association of Polish Surgeons (APS) clinical guidelines for the use of laparoscopy in the management of abdominal emergencies. Part I.

Sobocki¹,

Pędziwiatr²,

Bigda³

et al. 2023

Videosurgery and Other Miniinvasive Techniques

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Introduction Over the past three decades, almost every type of abdominal surgery has been performed and refined using the laparoscopic technique. Surgeons are applying it for more procedures, which not so long ago were performed only in the classical way. The position of laparoscopic surgery is therefore well established, and in many operations it is currently the recommended and dominant method. Aim The aim of the preparation of these guidelines was to concisely summarize the current knowledge on laparoscopy in acute abdominal diseases for the purposes of the continuous training of surgeons and to create a reference for opinions. Material and methods The development of these recommendations is based on a review of the available literature from the PubMed, Medline, EMBASE and Cochrane Library databases from 1985 to 2022, with particular emphasis on systematic reviews and clinical recommendations of recognized scientific societies. Recommendations were formulated in a directive form and evaluated by a group of experts using the Delphi method. Results and conclusions There are 63 recommendations divided into 12 sections: diagnostic laparoscopy, perforated ulcer, acute pancreatitis, incarcerated hernia, acute cholecystitis, acute appendicitis, acute mesenteric ischemia, abdominal trauma, bowel obstruction, diverticulitis, laparoscopy in pregnancy, and postoperative complications requiring emergency surgery. Each recommendation was supported by scientific evidence and supplemented with expert comments. The guidelines were created on the initiative of the Videosurgery Chapter of the Association of Polish Surgeons and are recommended by the national consultant in the field of general surgery. The first part of the guidelines covers 5 sections and the following challenges for surgical practice: diagnostic laparoscopy, perforated ulcer, acute pancreatitis, incarcerated hernia and acute cholecystitis. Contraindications for laparoscopy and the ERAS program are discussed.

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“…The effectiveness of AT is measured based on the recovery of the pretreatment clinical, radiological, and laboratory findings. It was seen in randomized clinical studies comparing antibiotics used in AC treatment that there was no significant difference between antibiotics 15,16 . Therefore, it is important to investigate whether or not applying the antibiotics that are used either singly or in combination has any difference in the treatment of the disease.…”

Section: Single Antibiotic (N=63)mentioning

confidence: 99%

Is combined rather than single antibiotic therapy actually reasonable in patients with acute calculous cholecystitis?

Alakuş

Peker

2021

Rev. Assoc. Med. Bras.

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OBJECTIVE: Acute calculous cholecystitis (AC) is a frequently encountered emergency surgery disease and its standard treatment is cholecystectomy. In patients with high risk in surgery, antibiotic treatment (AT) is important. In routine clinical practices, antibiotics are frequently used either as single or in combination in the treatment of AC. This study examined whether or not combined antibiotic treatment (CAT) had superiority over single antibiotic treatment (SAT) in AC. METHODS:Patients with cholecystitis who received treatment in the period of 2016-2019 were retrospectively examined. The treatment procedures applied, patient findings, and laboratory data were analyzed using relevant statistical software. The patients were categorized into groups based on the treatment approaches applied, and the effects of SAT and CAT on infection parameters were analyzed.RESULTS: In all, 184 patients received treatment for AC, with a mean age of 57.7, and the female-to-male ratio was 77:107. Of these, 139 patients received SAT and 45 received CAT. No significant difference was found in terms of effectiveness between the SAT and CAT in the patients who received early cholecystectomy treatment and those who received medical treatment with noninvasive intervention. CONCLUSIONS:In patients with AC, antibiotics are commonly used either as single or in combination for prophylaxis and therapeutic purposes. As no significant difference was observed between single and combined use in terms of treatment effectiveness and hospitalization duration, CAT is not recommended due to its possibility of allergic side effects, toxicity, and cost-increasing effects.

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Extended Postoperative Antibiotics Versus No Postoperative Antibiotics in Patients Undergoing Emergency Cholecystectomy for Acute Calculous Cholecystitis: A Systematic Review and Meta-Analysis

Cited by 11 publications

References 21 publications

Clinical significance of preoperative antibiotic use in mild to moderate acute inflammatory gallbladder disease: A randomized controlled trial

Clinical significance of preoperative antibiotic use in mild to moderate acute inflammatory gallbladder disease: A randomized controlled trial

The Association of Polish Surgeons (APS) clinical guidelines for the use of laparoscopy in the management of abdominal emergencies. Part I.

Is combined rather than single antibiotic therapy actually reasonable in patients with acute calculous cholecystitis?

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