A cross sectional study of risk factors for surgical site infections after laparoscopic and open cholecystectomy in a tertiary care hospital in North East India

Abstract

Background: Surgical site infection (SSI) after cholecystectomy unduly delays patients' early return to normal activities and also leaves behind relatively disfigured cosmetic scars at the port sites. This prospective study was undertaken to assess the various risk factors leading to SSI in patients undergoing cholecystectomy, both by laparoscopic and open techniques in this part of India for which no data is available at present. Material and Methods: A total of 1507 cholecystectomies (1184 by laparoscopy and 323 by open technique) during a 6 year period. The various risk factors studied were gender, age, BMI, DM, chronic anaemia, COPD, timing of surgery (elective or emergent), influence of surgeon (operated by resident surgeon or faculty), intraoperative bile spillage, etc., Odd's ratio was calculated to see the influence of the factors on SSI and statistical significance was tested by Chi-square test. Results: The overall rate of infection was 3.12% (1.94% in laparoscopy and 7.43% in the open technique). Intraoperative bile spillage, increasing age, increased duration of surgery, laparoscopic cholecystectomy done by resident surgeons, increased intraoperative blood loss, emergent operations done for acute cholecystitis, etc., were associated with higher rates of SSI. Conclusion: Meticulous operative techniques avoiding bile spillage and blood loss during cholecystectomy may reduce the chances of developing SSI.

A Systematic Review and Meta-Analysis of Bag Extraction Versus Direct Extraction for Retrieval of Gallbladder After Laparoscopic Cholecystectomy

“…The use of retrieval bags not only reduces the risk of bile spillage and SSI in cases of cholecystectomy but also minimizes the seeding of cancer cells on extracting cancerous specimens [ 39 , 40 ]. Intraoperative gallbladder perforations, bile, and stone spillage may mandate using a retrieval bag to contain peritoneal contamination and facilitate a clean and fast retrieval process [ 41 ].…”