Conclusions The use of prophylactic antibiotics is effective for reducing the incidence of SSI and superficial SSI but is not effective for preventing deep SSI in low-risk patients who underwent elective laparoscopic cholecystectomy
Background s/ Aims The role of prophylactic antibiotics for laparoscopic cholecystectomy in low-risk patients is still unclear .
This study aim ed to verify the conclusion of previous meta-analyses concerning the effectiveness of antibiotic prophylaxis for elective laparoscopic cholecystectomy in low-risk patients .
Routine Use of Prophylactic Antibiotics during Laparoscopic Cholecystectomy Does Not Reduce the Risk of Surgical Site Infections.
BACKGROUND  Laparoscopic cholecystectomy ( LC ) is the gold st and ard for the treatment of symptomatic gallbladder stones . As infections are rare in uncomplicated LC , it is widely accepted that prophylactic antibiotics need not be administered , and guidelines do not support routine antibiotic prophylaxis during elective LC . However , routine antibiotic prophylaxis for elective LC is still popular in many clinical setting s. We investigated this situation in our department . METHOD This r and omized double-blind controlled study included 570 patients who underwent LC between March 2007 and February 2010 . The exclusion criteria were antibiotic intake before surgery , steroid treatment , and the presence of pancreatitis , cholangitis , obstructive jaundice , cephalosporin allergy , or pregnancy . The patients were r and omized into three groups . Group 1 ( n = 193 ) received physiologic saline as placebo , Group 2 ( n = 191 ) received a first-generation cephalosporin ( cefazolin ; 1 g ) , and Group 3 ( n = 186 ) received a second-generation cephalosporin ( cefuroksim aksetil ; 750 mg ) . Bile and epigastric and umbilical port tissue sample s were harvested for culture . All patients were observed until the end of the fourth week after surgery . Patient age , sex , weight , American Society of Anesthesiologists ( ASA ) score , diabetes mellitus , smoking history , history of biliary colic in the past month , length of the hospital stay before the operation , operational findings ( acute or chronic cholecystitis ) , operation duration , use of drainage , type of prophylaxis administered if any , culture results , surgical site infection ( SSI ) development , and time to SSI development along with associated treatments were evaluated . RESULTS There was no statistically significant difference between the groups with respect to any of the demographic and clinical features analyzed in this study . The SSI rate was 1.2 % in total , and in Groups 1 , 2 , and 3 , it was 1.5 % , 1.04 % , and 1.07 % , respectively . There was no statistical difference regarding SSI among the groups ( p = 1.00 ) . Superficial SSI was observed in all groups , and in all patients , the site of infection was the entrance to the epigastric port through which the gallbladder had been removed . CONCLUSIONS Surgical site infection is rare after LC , and antibiotic prophylaxis does not appear to affect the outcome significantly . Moreover , factors such as positive bile cultures , history of biliary attack , ASA score , diabetes , obesity , and smoking do not have any effect on SSI development . Thus , we conclude that antibiotic prophylaxis is not needed for elective LC
Conclusions The use of prophylactic antibiotics is effective for reducing the incidence of SSI and superficial SSI but is not effective for preventing deep SSI in low-risk patients who underwent elective laparoscopic cholecystectomy
Background s/ Aims The role of prophylactic antibiotics for laparoscopic cholecystectomy in low-risk patients is still unclear .
This study aim ed to verify the conclusion of previous meta-analyses concerning the effectiveness of antibiotic prophylaxis for elective laparoscopic cholecystectomy in low-risk patients .