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The role of prophylactic antibiotics in elective laparoscopic cholecystectomy
Mehmet Uludag1, Gurkan Yetkin, Bulent Citgez
1Second Department of General Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey. drmuludag@hotmail.com
Insights
Prophylactic antibiotics are not necessary for low-risk patients undergoing laparoscopic cholecystectomy. This study found no significant difference in postoperative infection rates between patients who received antibiotics and those who did not.
Area of Science:
- Surgical Infection Prevention
- Gastrointestinal Surgery
Background:
- Elective laparoscopic cholecystectomy generally has low infectious complication rates.
- Prophylactic antibiotic use is common despite low risk.
Purpose of the Study:
- To evaluate the necessity and efficacy of prophylactic antibiotics.
- To assess impact on postoperative infection complications in low-risk patients.
Main Methods:
- Prospective study comparing two groups of low-risk patients.
- Group 1: received cefazolin (1g IV).
- Group 2: received no prophylactic antibiotics.
Main Results:
- No significant difference in surgical site infection (SSI) rates.
- Infection rates: Group 1 (4.41% wound, 4.41% pulmonary, 1.47% UTI); Group 2 (2.63% wound, 2.63% pulmonary, 3.95% UTI).
- Positive bile culture and gallbladder rupture did not significantly increase SSI rates.
Conclusions:
- Prophylactic antibiotics do not reduce postoperative infection or SSI rates.
- Antibiotics are not necessary for low-risk laparoscopic cholecystectomy patients.
- Current practice of routine antibiotic prophylaxis may be reconsidered.
Background And Objectives:
Elective laparoscopic cholecystectomy has a low risk for infectious complications, but many surgeons still use prophylactic antibiotics. The aim of this prospective study was to investigate the necessity and test the efficacy of prophylactic antibiotics on postoperative infection complications in low-risk patients undergoing laparoscopic cholecystectomy.
Methods:
Low-risk patients were randomly placed into 2 groups: 68 patients (group 1) received cefazolin 1g intravenously after induction of anesthesia, and 76 patients (group 2) were not given prophylactic antibiotics. In both groups, septic complications were recorded and compared.
Results:
Positive bile culture and gallbladder rupture did not significantly increase the rate of surgical site infections. In group 1, there were 3 (4.41%) cases of wound infection, 3 (4.41%) cases of pulmonary infections, and 1 (1.47%) case of urinary tract infection. In group 2, there were 2 (2.63%) cases of wound infection, 2 (2.63%) case of pulmonary infections, and 3 (3.95%) cases of urinary tract infection. No significant difference existed in the complication rates.
Conclusions:
Based on our data, the use of prophylactic antibiotics does not decrease the rate of postoperative infection complications and surgical-site infections and is not necessary in low-risk patients undergoing laparoscopic cholecystectomy.
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