Bile Spillage as a Risk Factor for Surgical Site Infection after Laparoscopic Cholecystectomy: A Prospective Study of 1,001 Patients

Peponis, Thomas; Eskesen, Trine G.; Mesar, Tomaž; Saillant, Noelle; Kaafarani, Haytham M.A.; Yeh, D. Dante; Fagenholz, Peter J.; Moya, Marc A. de; King, David R.; Velmahos, George C.

doi:10.1016/j.jamcollsurg.2017.11.025

Cited by 22 publications

(26 citation statements)

References 23 publications

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“…Bile spillage was a reason to insert a drain after open cholecystectomy 24 and associated with surgical site infections. 25 Third, the characteristics of included patients were not consistent among studies leading to some heterogeneity in our overall analyses. In the study of Kim, 10 the patients were composed of acute edematous cholecystitis, gallbladder empyema, and even gallbladder gangrene.…”

Section: Discussionmentioning

confidence: 94%

Drainage versus No Drainage after Laparoscopic Cholecystectomy for Acute Cholecystitis: A Meta-Analysis

Tao

2019

The American Surgeon

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To conduct a randomized controlled trial (RCT), meta-analysis to assess the effectiveness of drains in reducing complications after laparoscopic cholecystectomy (LC) for acute cholecystitis needs to be carried out. An electronic search of PubMed, Embase, Science Citation Index, and the Cochrane Library from January 1990 to January 2018 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in LC for acute cholecystitis. The outcomes were calculated as odds ratios (ORs) with 95 per cent confidence intervals (CIs) using RevMan 5.2. Four RCTs, which included 796 patients, were identified for analysis in our study. There was no statistically significant difference in the rate of morbidities (OR = 1.23, 95% CI 0.55–2.76, P = 0.61). Abdominal pain was more severe in the drain group 24 hours after surgery (mean difference = 0.80, 95% CI 0.47–1.14; P < 0.00001). No significant difference was present with respect to wound infection rate and hospital stay. The use of abdominal drainage does not appear to be of any benefit in patients having undergone early LC for acute cholecystitis.

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Section: Discussionmentioning

confidence: 94%

Drainage versus No Drainage after Laparoscopic Cholecystectomy for Acute Cholecystitis: A Meta-Analysis

Tao

2019

The American Surgeon

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“…Peponis and colleagues reported that bile spillage occurred in 591 of 1001 patients (59.0%) undergoing laparoscopic cholecystectomy for AC and other biliary diseases in their prospective study, and was associated with postoperative SSI development. 16 In cases with bile spillage during a cholecystectomy for AC, an abdominal drain was often placed. A recent systematic review reported that there is no significant advantage to drain placement in postoperative outcomes including SSI after an elective laparoscopic cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Intraoperative bile spillage and abdominal drain placement after cholecystectomy for AC are other factors to be discussed in the postoperative management for SSI prevention. Peponis and colleagues reported that bile spillage occurred in 591 of 1001 patients (59.0%) undergoing laparoscopic cholecystectomy for AC and other biliary diseases in their prospective study, and was associated with postoperative SSI development 16 . In cases with bile spillage during a cholecystectomy for AC, an abdominal drain was often placed.…”

Section: Discussionmentioning

confidence: 99%

Gram staining of gallbladder bile samples is useful for predicting surgical site infection in acute cholecystitis patients undergoing an early cholecystectomy

Nishida

Otagiri

Yoshifuku

et al. 2020

J Hepato Biliary Pancreat

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Acute cholecystitis (AC) is one of the most frequently encountered diagnoses in the emergency room, with its prevalence increasing worldwide. 1-3 The recommended treatment is an early cholecystectomy, which ought to be performed close to the time of the disease onset. 1 A common complication after cholecystectomy for AC is surgical site infection (SSI); its rate has been reported to be almost 10 percent. 4 For the prevention and control of such infection, multimodal strategies and multidisciplinary efforts are needed. The microbiological assessment of gallbladder bile is essential for management in AC patients. 5 Usually, a bacterial culture profile is used for SSI management; however,

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“…The aim of this study was to evaluate the feasibility and efficacy of SIRC and to compare clinical outcomes between SIRC and SILC. 21,22 which indicates that bile spillage can be an indicator of surgical stability. In our study, we found bile spillage to be more common in SILC patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy

Lee

Lim

2021

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims: Multiport laparoscopic cholecystectomy is the standard surgical procedure for symptomatic gallbladder diseases. However, as a result of the ongoing trend toward minimally invasive laparoscopy, single-incision laparoscopic cholecystectomy (SILC) has evolved. Single-incision robotic cholecystectomy (SIRC) can overcome several limitations of manual SILC. The purpose of this study is to evaluate and compare the safety and feasibility of SIRC and SILC. Methods: This study retrospectively reviewed data for all patients who underwent SIRC or SILC from March 2018 to July 2019 in a single institution. The following variables were analyzed: age, sex, body mass index, pain scale, length of stay, and complications. The data were analyzed using the Independent two sample t-test or the Fisher's exact test. Results: A total of 343 patients underwent SIRC or SILC during the study period. After excluding patients with acute cholecystitis, 197 SIRC and 103 SILC patients were analyzed in this study. The surgery time and postoperative hospital stay did not differ between SIRC and SILC. However, the SIRC patients experienced less bile spillage during the surgery than did the SILC patients (SIRC vs. SILC: 24 (23.3%) vs. 11 (5.6%) cases, respectively; p＜0.001). Although there was no difference in the incidence of postoperative complications between procedures, additional pain control was administered more frequently in SILC patients (SILC 1.08±0.893, SIRC 0.58±0.795; p＜0.001). Conclusions: While both SILC and SIRC are effective for single-incision cholecystectomy, SIRC was superior to SILC in terms of technical stability. Moreover, it has the advantage of postoperative pain control.

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Bile Spillage as a Risk Factor for Surgical Site Infection after Laparoscopic Cholecystectomy: A Prospective Study of 1,001 Patients

Cited by 22 publications

References 23 publications

Drainage versus No Drainage after Laparoscopic Cholecystectomy for Acute Cholecystitis: A Meta-Analysis

Drainage versus No Drainage after Laparoscopic Cholecystectomy for Acute Cholecystitis: A Meta-Analysis

Gram staining of gallbladder bile samples is useful for predicting surgical site infection in acute cholecystitis patients undergoing an early cholecystectomy

Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy

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