Yonsei Med J.  2021 Feb;62(2):172-176. 10.3349/ymj.2021.62.2.172.

Prospective Control Study of Clinical Effectiveness of Prophylactic Antibiotics in Laparoscopic Cholecystectomy on Infection Rate

Affiliations
  • 1Department of Surgery, Jeonbuk National University Hospital, Jeonju, Korea.
  • 2Biomedical Research Institute, Jeonbuk National University Hospital, Jeonju, Korea.
  • 3Research Institute of Clinical Medicine of Jeonbuk National University, Jeonju, Korea.

Abstract

Purpose
This study evaluated the effectiveness of prophylactic antibiotics in elective laparoscopic cholecystectomy (LCC) for the reduction of postoperative infection rate.
Materials and Methods
Elective LCC was performed on 529 patients at Jeonbuk National University Hospital between April 2015 and August 2017. A total of 509 patients were enrolled based on the inclusion criteria. This prospective study compared the results for antibiotic group (AG) (n=249, cefotetan 1 g, 1 dose/prophylactic) and non-antibiotic group (NAG) (n=260).
Results
There were no significant differences in clinical characteristics between the two groups: AG and NAG (p=0.580, 0.782, and 0.325, respectively). Levels of C-reactive protein were higher in NAG compared to AG at postoperative day 2 (16.6±24.2 vs. 24.2±40.6; p=0.033). There were no significant differences in white blood cell counts and erythrocyte sedimentation rate. Fever ≥38℃ on postoperative day 2 occurred in 3 (1.2%) and 9 (3%) patients in AG and NAG, respectively. One patient in each group had subhepatic fluid collection by abdominal computed tomography, but there was no evidence of infection. Two patients in NAG (3%) had serous wound drainage on postoperative day 14.
Conclusion
Our results showed no significant differences in patients receiving or not receiving prophylactic antibiotics during LCC. Therefore, it is not necessary to use prophylactic antibiotics during elective LCC in patients who meet the inclusion criteria.

Keyword

Laparoscopic cholecystectomy; prophylactic antibiotics; infection
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