Abstract
Laparoscopic cholecystectomy has become the new gold standard for management of symptomatic gallstones. Prophylactic antibiotics are used in elective surgery by the majority of surgeons, and their role in biliary tract surgery has been well established for a subpopulation of high-risk patients. This consensus has been derived from multiple studies involving biliary tract surgery before and in the era of laparoscopic cholecystectomy. But the use of prophylactic antibiotics in laparoscopic cholecystectomy especially in the low-risk group is now controversial and varied among the surgeons all over the world. To study the role of prophylactic antibiotics in laparoscopic cholecystectomy in different risk groups of patients, a prospective study was conducted in the Department of Surgery of Bankura Sammilani Medical College and Hospital from January 2010 to July 2011. All patients with symptomatic gallstones who underwent elective laparoscopic cholecystectomy during this period are included in this study. One hundred and two patients with symptomatic gallstones were operated on by laparoscopic technique without receiving preoperative antibiotics and studied over a period of 1.5 years. Ages ranged from 11 to 70 years (mean age of 33 years). There were 14 males (13.72 % of the patients) and 88 females (86.27 % of the patients). There was no wound infection (class I) in 99 patients, and class II type of wound infection, i.e., surgical site infection, occurred in three patients (i.e., 2.94 %) out of a total of 102 patients. Swabs were taken for culture and sensitivity; Staphylococcus aureus was found in two patients and Streptococcus viridans in one patient. In all three patients, infection occurred at the umbilical port sites, detected on the 3rd and 4th postoperative days. Antibiotic prophylaxis is not necessary in low-risk patients with symptomatic gallstone disease undergoing elective laparoscopic cholecystectomy to prevent postoperative infection-related complications. Preoperative skin preparation with chlorhexidine gluconate scrub may replace the use of prophylactic antibiotics for prevention of infection-related complications in patients undergoing elective laparoscopic cholecystectomy.
Similar content being viewed by others
References
Reddick EJ, Olsen DO (1989) Laparoscopic laser cholecystectomy: a comparison with mini-lap cholecystectomy. Surg Endosc 3:131–133
Frantzides CT, Sykes A (1994) Reevaluation of antibiotic prophylaxis in laparoscopic cholecystectomy. J Laparoendosc Surg 4(6):375–378
Watkin DS, Wainwright AM, Thompson MH, Leaper DJ (1995) Infection after laparoscopic cholecystectomy: are antibiotics really necessary? Eur J Surg 161:509–511
Zucker KA, Bailey RW, Gadacy T et al (1991) Laparoscopic guided cholecystectomy. Am J Surg 161:36–44
Mealy K, Gallager H, Barry M, Lennon F, Traynor O, Hyland J (1992) Physiological and metabolic responses to open and laparoscopic cholecystectomy. Br J Surg 79:1061–1064
Fisher KS, Matteson KM, Hammer MD (1993) Laparoscopic cholecystectomy: the Springfield experience. Surg Laparosc Endosc 3:199–203
Ulualp K, Condon RE (1992) Antibiotic prophylaxis for scheduled operative procedures. Infect Dis Clin North Am 6:613–625
Koc M, Zulfikaroglu B, Kece C, Ozalp N (2003) A prospective randomized study of prophylactic antibiotics in elective laparoscopic cholecystectomy. Surg Endosc 17:1716–1718
Kuthe SA, Kaman L, Verma GR, Singh R (2006) Evaluation of the role of prophylactic antibiotic in elective laparoscopic cholecystectomy: a prospective randomized trial. Trop Gatroenterol 27:54–57, Jan–Mar
Yildiz B, Abbasoglu O, Tirnaksiz B, Hamaloglu E, Ozdemir A, Sayek I (2009) Determinants of postoperative infection after laparoscopic cholecystectomy. Hepatogastroenterology 56(91–92):589–592, May–Jun
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Mandal, N., Nandy, M.M., Majhi, J. et al. Laparoscopic Cholecystectomy Without Prophylactic Antibiotics: A Prospective Study. Indian J Surg 77 (Suppl 2), 419–422 (2015). https://doi.org/10.1007/s12262-013-0857-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12262-013-0857-9