Modern Elective Laparoscopic Cholecystectomy Carries Extremely Low Postoperative Infection Risk

Ely, Sora; Rothenberg, Kara A.; Beattie, Genna; Gologorsky, Rebecca C.; Huyser, Michelle R; Chang, Ching-Kuo

doi:10.1016/j.jss.2019.09.038

Cited by 19 publications

(37 citation statements)

References 15 publications

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“…SSI rates in laparoscopic cholecystectomy are 0.5–1.5%, comparable to the expected infection rate of clean cases and far lower than open cholecystectomy [ 44 ]. In a retrospective review of an extensive U.S. national database, all patient-related factors indicated in the current guidelines were significantly associated with SSI [ 45 ]. The role of high-risk features is less clear based on bile spillage or bacterial colonization.…”

Section: Resultsmentioning

confidence: 99%

Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery—A Systematic Review

et al. 2022

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Background: Surgical site infections (SSIs) are among the most important determinants of morbidity after HBP surgery. Their frequency after HPB surgery is variable, from 1–2% after elective cholecystectomy to 25% after PD. Methods: A systematic review was performed to assess the role of antimicrobial prophylaxis (AP) in HPB elective surgery. Articles published between 2015 and 2021 were obtained; those before 2015 were not included because they antedate the WHO guidelines on SSI prevention. We conducted three different research methods for liver resection, elective cholecystectomy and pancreatic and biliary surgery regarding patients requiring preoperative biliary drainage. Results: Hepatic surgery, improvement in surgical technique and perioperative management lead to a very low SSI. One preoperative 2 g cefazolin dose may be adequate for surgical prophylaxis. From preoperative biliary drainage, we can derive that patients’ homeostasis rather than AP plays a paramount role in reducing postoperative morbidity. The time from biliary drainage could be an essential element in decision making for surgical prophylaxis. In the case of low-risk cholecystectomy, it is not easy to draw definitive conclusions about the effect of AP. Data from the literature are inconsistent, and some risk factors cannot be predicted before surgery. Conclusion: in our opinion, a strict preoperative cefazolin dose strategy can be reasonable in HBP surgery until a large-scale, multicentric RCT brings definitive conclusions.

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Section: Resultsmentioning

confidence: 99%

Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery—A Systematic Review

et al. 2022

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“…LC is considered a safe procedure, as compared to clean procedures, particularly in elective cases and on patients with no risk factors 6 . Studies indicate that cholecystectomy can even be performed simultaneously with other procedures without increasing the risk of infection 3 .…”

Section: Discussionmentioning

confidence: 99%

“…Studies indicate that cholecystectomy can even be performed simultaneously with other procedures without increasing the risk of infection 3 . The incidence of infection is around 0.71-8.7% 2 , 5 , 6 , 8 , 10 , 11 , 12 , 20 , 21 , 22 , 26 , 27 , 28 , 29 , 30 , 31 , 32 . There are a growing number of results that do not demonstrate a significant correlation between ABP in low-risk procedures and a reduction in infection rates 2 , 5 , 7 , 8 , 19 , 20 , 24 , 26 , 27 , 28 , 30 , 33 .…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Gamo

Reichardt

Guetter

et al. 2022

ABCD, arq. bras. cir. dig.

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- BACKGROUND: One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with certain risk factors for infection. However, some guidelines suggest the use of antibiotic prophylaxis for all cholecystectomies, although current evidence does not indicate any advantage of this practice in the absence of risk factors. AIM: This study aimed to evaluate the incidence of wound infection after elective laparoscopic cholecystectomies and the use of antibiotic prophylaxis in these procedures. METHODS: This is a retrospective study of 439 patients with chronic cholecystitis and cholelithiasis, accounting for different risk factors for wound infection. RESULTS: There were 7 (1.59%) cases of wound infection. No antibiotic prophylaxis regimen significantly altered infection rates. There was a statistically significant correlation between wound infection and male patients (p=0.013). No other analyzed risk factor showed a statistical correlation with wound infection. CONCLUSIONS: The non-use of antibiotic prophylaxis and other analyzed factors did not present a significant correlation for the increase in the occurrence of wound infection. Studies with a larger sample and a control group without antibiotic prophylaxis are necessary.

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“…Estos resultados, si bien son elevados, deben ser analizados en el contexto de nuestro hospital, que es un centro de referencia de nuestra comunidad para cirugía hepá tica y pancreá tica compleja. En cuanto a las colecistectomías, la tasa de ISQ fue del 1,5%, un resultado inferior a lo publicado, si tenemos en cuenta que la mayoría de los pacientes infectados fueron intervenidos de urgencia y por vía abierta 5,7 .…”

Section: Discusió Nunclassified

“…En cuanto a la colecistectomía se refiere, las tasas de ISQ se sitú an en torno a un 7% en cirugía abierta y apenas en un 1% en cirugía laparoscó pica cirugía electiva 5,7 .…”

Section: Introducció Nunclassified

Infección del sitio quirúrgico en cirugía hepatobiliopancreática y su relación con la concentración sérica de vitamina D

et al. 2020

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c i r e s p . 2 0 2 0 ; x x ( x x ) : x x x -x x x informació n del artículo Historia del artículo: Recibido el 31 de octubre de 2019 Aceptado el 9 de marzo de 2020 On-line el xxx Palabras clave: Cirugía hepatobiliopancreá tica Infecció n nosocomial Infecció n del sitio quirú rgico Vitamina D r e s u m e nIntroduccio´n: La relació n entre las infecciones nosocomiales en pacientes quirú rgicos y la vitamina D ha sido estudiada por algunos autores. Sin embargo, hasta la fecha no existe ningú n estudio realizado sobre pacientes de cirugía hepatobiliar. El objetivo de nuestro trabajo es estudiar la infecció n del sitio quirú rgico (ISQ) en la unidad de cirugía hepatobiliar, y valorar su relació n con la concentració n sé rica de vitamina D.Me´todos: Se llevó a cabo un estudio analítico observacional de pacientes sucesivos intervenidos en la unidad de cirugía hepatobiliar de nuestro centro durante un añ o. Se incluyeron las intervenciones relativas a enfermedad biliar, pancreá tica y hepá tica. Se determinaron los niveles de vitamina D al ingreso, así como las ISQ de tipo superficial, profunda y ó rganocavitaria diagnosticadas durante el estudio. El seguimiento del paciente se realizó durante al menos un mes tras la cirugía, dependiendo de la enfermedad. La estadística se realizó mediante el programa estadístico R v.3.1.3.Resultados: La muestra quedó constituida por 321 pacientes, de los cuales el 25,8% presentó ISQ a expensas fundamentalmente de las infecciones ó rgano-cavitarias que presentaron una incidencia del 24,3%. Concentraciones sé ricas superiores a 33,5 nmol/l demostraron reducir en un 50% el riesgo de ISQ.Conclusiones: Las concentraciones elevadas de vitamina D en sangre demostraron ser un factor protector frente a las ISQ (OR: 0,99). Nuestros resultados sugieren una relació n directa entre la concentració n sé rica de vitamina D y la ISQ, justificando la realizació n de nuevos estudios prospectivos.

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Modern Elective Laparoscopic Cholecystectomy Carries Extremely Low Postoperative Infection Risk

Cited by 19 publications

References 15 publications

Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery—A Systematic Review

Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery—A Systematic Review

Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Infección del sitio quirúrgico en cirugía hepatobiliopancreática y su relación con la concentración sérica de vitamina D

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