What Should be Done for Perforation of the Gallbladder During Laparoscopic Cholecystectomy: Prophylaxis or Treatment?

Karabulut, Zülfikar; Güler, Yılmaz; Doğan, Pașa; Şengül, Serkan; Çalış, Hasan

doi:10.1089/lap.2020.0322

Cited by 9 publications

(9 citation statements)

References 25 publications

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“…The incidence of gallbladder perforation was 2.73%. This value is in line with the lowest rates reported in literature, which shows a large variation ranging between 1.5 and 35.1% 2 , 5 , 8 , 10 , 11 , 12 , 26 , 27 , 28 , 30 , 31 . There is a possibility for underreporting, as it is a common occurrence with this procedure and may not be included in the medical records by the surgeon 30 .…”

Section: Discussionsupporting

confidence: 91%

“…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%

“…In this study, the incidence of WI was 1.59%, which is consistent with known literature. The risk factors evaluated were chosen based on international guidelines, in addition to studies that found a significant correlation to WI 1 , 4 , 5 , 6 , 8 , 10 , 11 , 13 , 21 , 22 , 26 , 28 , 29 , 30 , 31 , 32 . The predominant epidemiological profile in this study was consistent with the literature, with a prevalence given to female patients aged between 30 and 50 years.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Gamo

Reichardt

Guetter

et al. 2022

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

show abstract

“…The incidence of gallbladder perforation was 2.73%. This value is in line with the lowest rates reported in the literature, which shows a large variation, i.e., between 1.5 and 35.1% 2 , 5 , 8 , 10 – 12 , 26 – 28 , 30 , 31 . It is possible that there is underreporting, as it is a common occurrence with this procedure, and may not be included in the medical records by the surgeon 30 .…”

Section: Discussionsupporting

confidence: 90%

Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Gamo

Reichardt

Guetter

et al. 2022

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

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. AIMS: This study aims 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 seven cases of wound infection (1.59%). 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 nonuse 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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“…SSI rates were significantly higher in patients with perforation, but they observed no difference in length of post-operative stay [ 46 ]. However, in this subgroup of patients, a single antibiotic dose effectively reduces the SSI rate [ 47 , 48 ].…”

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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What Should be Done for Perforation of the Gallbladder During Laparoscopic Cholecystectomy: Prophylaxis or Treatment?

Cited by 9 publications

References 25 publications

Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Antibiotic Prophylaxis for Hepato-Biliopancreatic Surgery—A Systematic Review

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