Role of Prophylactic Antibiotics in Laparoscopic Cholecystectomy

Gaur, Abha; Pujahari, AK

doi:10.1016/s0377-1237(10)80043-7

Cited by 21 publications

(22 citation statements)

References 6 publications

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“…). After exclusions, a total of 19 studies remained with 5259 participants, of whom 2709 (51·5 per cent) were administered perioperative antibiotics. Table summarizes the design, sample sizes, setting, participants, interventions and outcomes of eligible studies published between 1997 and 2015.…”

Section: Resultsmentioning

confidence: 99%

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Meta-analysis of perioperative antibiotics in patients undergoing laparoscopic cholecystectomy

Pasquali

Boal

Griffiths

et al. 2016

Journal of British Surgery

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Section: Resultsmentioning

confidence: 99%

“…Fifteen studies reported infections by postoperative day (POD) 30, and one by POD 7. Information regarding timing of the outcome was missing in three studies.…”

Section: Resultsmentioning

confidence: 99%

Meta-analysis of perioperative antibiotics in patients undergoing laparoscopic cholecystectomy

Pasquali

Boal

Griffiths

et al. 2016

Journal of British Surgery

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“…[6,[9][10][11] In a randomized controlled trial by Gaur et al on 417 patients undergoing laparoscopic cholecystectomy, an overall infection rate was 2.2%, which is consistent with the results obtained in our study. [12] In the present study, we had higher incidence of bile spillage (20%, n=48, N=240). Possible cause could be involvement of acute cases (10%) and different levels of operating surgeons, though all of them were experienced about the procedure.…”

Section: Discussionmentioning

confidence: 39%

Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis

Thapa¹,

Kher²,

Tambay³

2017

J Lumbini Med Coll

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Introduction: Surgical site infection is a common complication shown in literature following cholecystectomies. Smaller incision and use of trocars in laparoscopic cholecystectomy lessen the contamination resulting in less chances of surgical site infection. However, in fear of postoperative infection, many opt for the prolonged postoperative use of antibiotic and there is growing consensus against it. Antibiotics not only increases the cost and hospital stay duration but it aids in emergence of multidrug resistance. Because of the controversies, we conducted this clinical trial to see whether a single prophylactic dose of antibiotic at the time of induction of anesthesia for laparoscopic cholecystectomy was equally effective in controlling post-operative infection as multi-dose antibiotics during and post-operative period. Methods: The study was conducted at the department of general surgery, Lumbini Medical College Teaching Hospital, from November 2015 to October 2016. All cases with symptomatic cholelithiasis subjected for laparoscopic cholecystectomy were enrolled. Patients were randomized into two groups; Group SD received single dose of an intravenous dose of amikacin 500 mg, at induction of anesthesia and Group MD received multiple intravenous dose of amikacin, during and postoperatively for two days. Complications, hospital stay, and treatment cost in two groups were compared and analyzed. Results: There were a total of 240 patients in the study, 118 in Group SD and 122 in Group MD. Post-operative infection rate was 4.2% (n= 5, N=118) in Group SD and 3.3% (n=4, N=122) in Group MD; the difference was not significant (p=0.75). Hospital stay was prolonged and cost was higher significantly in Group MD. Conclusion: Single dose of prophylactic antibiotic, administered at induction of anesthesia, is equally effective as multiple doses of post surgical antibiotics to prevent post-operative infection in patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis.

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“…Our results showed that the overall prevalence of bacteria within bile sampled at uncomplicated LC was 8.2% while it was 2.8% -25 % in different reported studies (7,(14)(15)(16). The lower rate of bactobilia has been reported among patients who underwent LC (2.8%), when compared to the overall rate of 13.3% in patients undergoing open cholecystectomy (7).…”

Section: Discussionmentioning

confidence: 45%

“…In one patient, we isolated acinetobacter the risk factor, and the possibility of this type of contamination related to the hospital, and it is not expected to be isolated from healthy non-hospitalized patients. It was shown recently that prolonged bile duct obstruction leads to an impaired intestinal wall barrier and as a result, bacteria can colonize bile easier, thus, it is not surprising that gramnegative enteric bacteria, especially E. coli, are the most common bacteria causing bactobilia in many studies including ours (13)(14)(15)(16)(17)(18). In our study, imipenem and aminoglycosides, especially amikacin, were the most effective antibiotics.…”

Section: Discussionmentioning

confidence: 81%

Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications

Ghahramani¹,

Jahromi²,

Pouladfar³

et al. 2017

Ann Colorectal Res

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Background: Determining the rate of bactibilia among patients under going laparoscopic cholecystectomy (LC) and its correlations with predisposing factors and postoperative infections, which help evaluate the need for prophylactic antibiotic. Methods: In this prospective study, 85 consecutive patients with uncomplicated cholelithiasis who underwent LC were enrolled from 2012 to 2013. Routine bile culture was done at the time of LC. Patients were divided into 2 groups, 1 with negative bile culture and another with bactibilia. Demographic and laboratory data were compared. Patients were followed up 10 days after their laparoscopy and 1 month after discharge to monitor the presence of infection. Results: A total of 7 cultures of bile were positive for bacteria (8.2 %). The patients' age was the sole factor with a significant relationship with the rate of bactobilia (P = 0.016). Within 10 days after surgery, fever and surgical site infection were detected in 10.6% of patients, which was not significantly different in the 2 groups. There were no complications in the 30-day follow-up. Conclusions: Detecting bactobilia with low frequency and the lack of correlation between bactobilia and postoperative infectious, complications did not support prescribing prophylactic antibiotic in respective patients. The older age was the sole predisposing factor for the development of bactobilia.

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Role of Prophylactic Antibiotics in Laparoscopic Cholecystectomy

Abstract: Background: Antibiotic prophylaxis is routinely administered in laparoscopic cholecystectomy but its role is debatable.

Cited by 21 publications

References 6 publications

Meta-analysis of perioperative antibiotics in patients undergoing laparoscopic cholecystectomy

Meta-analysis of perioperative antibiotics in patients undergoing laparoscopic cholecystectomy

Single dose Intraoperative Antibiotics versus Postoperative Antibiotics for Patient Undergoing Laparoscopic Cholecystectomy for Symptomatic Cholelithiasis

Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications

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