Ann Surg Treat Res.  2017 Aug;93(2):76-81. 10.4174/astr.2017.93.2.76.

Are prophylactic antibiotics necessary in elective laparoscopic cholecystectomy, regardless of patient risk?

Affiliations
  • 1Department of Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Korea. d002045@gmail.com

Abstract

PURPOSE
The average rate of surgical site infections (SSIs) for laparoscopic cholecystectomy (LC) has been reported in the literature to be between 0.4% and 6.3%. Also, these recent reviews have concluded that a prophylactic antibiotics for elective LCs in low-risk patients is not useful, but there were no results in high-risk patients.
METHODS
The aim of this study was to investigate the role of a single dose of first-generation cephalosporin as a prophylactic antibiotic for patients undergoing elective LC, regardless of patient risk. This randomized clinical trial was conducted from October 2013 to December 2014 by single surgeon at our hospital. Patients were randomized into two groups by following method. Odd-numbered patients (group A) received 1-g cefazolin intravenously within 30 minutes before incision, whereas even-numbered patients (group B) received normal saline intravenously instead of prophylactic antibiotics, with the aim of including 100 patients in each group. SSIs were recorded and compared between the groups.
RESULTS
There were no differences in preoperative demographics and postoperative findings between the groups. There were no superficial and deep SSIs in either group, 9 cases of superficial seromas developed (4.5%) in the cohort: 4 in group A (4%) and 5 in group B (5%). There were no significant associations between SSIs and the use of prophylactic antibiotics in either group. Additionally, the high-risk group did not show a significantly increased rate of SSIs.
CONCLUSION
Based on our study, prophylactic antibiotics are not necessary in elective LC, regardless of patient risk.

Keyword

Laparoscopic cholecystectomy; Antibiotic prophylaxis; Surgical wound infection

MeSH Terms

Anti-Bacterial Agents*
Antibiotic Prophylaxis
Cefazolin
Cholecystectomy, Laparoscopic*
Cohort Studies
Demography
Humans
Methods
Seroma
Surgical Wound Infection
Anti-Bacterial Agents
Cefazolin

Cited by  1 articles

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis
Sang Hoon Kim, Hee Chul Yu, Jae Do Yang, Sung Woo Ahn, Hong Pil Hwang
Ann Hepatobiliary Pancreat Surg. 2018;22(3):231-247.    doi: 10.14701/ahbps.2018.22.3.231.


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