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Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
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Laparoscopic Cholecystectomy Without Prophylactic Antibiotics: A Prospective Study.

Nilay Mandal1, Mintu Mohan Nandy1, Jaganmay Majhi1

  • 1Department of Surgery, Bankura Sammilani Medical College and Hospital, Bankura, West Bengal India.

The Indian Journal of Surgery
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PubMed
Summary

Prophylactic antibiotics are not necessary for low-risk patients undergoing laparoscopic cholecystectomy for symptomatic gallstones. Preoperative skin preparation may be a sufficient alternative to prevent surgical site infections.

Keywords:
Laparoscopic cholecystectomyPreoperative antibioticsWound infection

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Area of Science:

  • Surgical Innovation
  • Infectious Disease Prevention
  • Gastrointestinal Surgery

Background:

  • Laparoscopic cholecystectomy is the standard for symptomatic gallstones.
  • Prophylactic antibiotics are common but their necessity in low-risk patients is debated.
  • Existing guidelines are based on older surgical techniques and high-risk populations.

Purpose of the Study:

  • To evaluate the necessity of prophylactic antibiotics in low-risk patients undergoing elective laparoscopic cholecystectomy.
  • To assess the incidence of surgical site infections in patients not receiving prophylactic antibiotics.
  • To explore alternative infection prevention methods.

Main Methods:

  • Prospective study of 102 patients undergoing elective laparoscopic cholecystectomy.
  • Patients did not receive preoperative antibiotics.
  • Postoperative monitoring for wound infection and surgical site infection (SSI).
  • Culture and sensitivity testing for identified infections.

Main Results:

  • Only 2.94% of patients (3 out of 102) developed surgical site infections (SSI).
  • Infections occurred at the umbilical port site and were treated successfully.
  • Identified pathogens included Staphylococcus aureus and Streptococcus viridans.

Conclusions:

  • Prophylactic antibiotics are not required for low-risk patients with symptomatic gallstones undergoing elective laparoscopic cholecystectomy.
  • Chlorhexidine gluconate skin preparation may effectively prevent SSIs in this patient group.
  • This finding challenges current practices and suggests a more targeted antibiotic approach.