Infections and bacteriological data after laparoscopic and open gallbladder surgery

Hoed, P.T. den; Boelhouwer, Roelof U.; Veen, H. F.; Hop, Wcj; Bruining, H. A.

doi:10.1016/s0195-6701(98)90240-7

Cited by 78 publications

(47 citation statements)

References 20 publications

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“…In the present study, there was no correlation between bactobilia and postoperative infectious complications, which is in agreement with some other studies (6,7,12,17). On the contrary, some studies have reported a higher incidence of postoperative infectious complications in patients in where bactobilia was detected, especially when cholecystectomy is performed in patients with complicated gallstone disease (13).…”

Section: Discussionsupporting

confidence: 92%

“…Our results showed that the overall prevalence of bacteria within bile sampled at uncomplicated LC was 8.2% while it was 2.8% -25 % in different reported studies (7,(14)(15)(16). The lower rate of bactobilia has been reported among patients who underwent LC (2.8%), when compared to the overall rate of 13.3% in patients undergoing open cholecystectomy (7).…”

Section: Discussionmentioning

confidence: 46%

“…The rate of post-operative wound infection after elective cholecystectomy in uncomplicated symptomatic gallstone ranges from 2.3% to 20% (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

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Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications

Ghahramani¹,

Jahromi²,

Pouladfar³

et al. 2017

Ann Colorectal Res

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Background: Determining the rate of bactibilia among patients under going laparoscopic cholecystectomy (LC) and its correlations with predisposing factors and postoperative infections, which help evaluate the need for prophylactic antibiotic. Methods: In this prospective study, 85 consecutive patients with uncomplicated cholelithiasis who underwent LC were enrolled from 2012 to 2013. Routine bile culture was done at the time of LC. Patients were divided into 2 groups, 1 with negative bile culture and another with bactibilia. Demographic and laboratory data were compared. Patients were followed up 10 days after their laparoscopy and 1 month after discharge to monitor the presence of infection. Results: A total of 7 cultures of bile were positive for bacteria (8.2 %). The patients' age was the sole factor with a significant relationship with the rate of bactobilia (P = 0.016). Within 10 days after surgery, fever and surgical site infection were detected in 10.6% of patients, which was not significantly different in the 2 groups. There were no complications in the 30-day follow-up. Conclusions: Detecting bactobilia with low frequency and the lack of correlation between bactobilia and postoperative infectious, complications did not support prescribing prophylactic antibiotic in respective patients. The older age was the sole predisposing factor for the development of bactobilia.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 46%

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Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications

Ghahramani¹,

Jahromi²,

Pouladfar³

et al. 2017

Ann Colorectal Res

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“…The SIGN recommendations were based on analysis of four studies assessing the role of antibiotics in elective surgery [2][3][4][5] and even though none of these papers were randomised controlled trials (RCTs), the indirect evidence was in favour of not prescribing prophylactic antibiotics in LC. 6 Six RCTs have been published since the publication of the SIGN recommendations, all dealing with elective LC and all concluding that no prophylactic antibiotics are required.…”

mentioning

confidence: 99%

A selective antibiotic prophylaxis policy for laparoscopic cholecystectomy is effective in minimising infective complications

Yanni

Mekhail

Morris‐Stiff

2013

annals

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INTRODUCTION It has been demonstrated previously that the identification of bactibilia during cholecystectomy is associated with the presence of one or more risk factors: acute cholecystitis, common duct stones, emergency surgery, intraoperative findings and age >70 years. Current evidence-based guidance on antibiotic prophylaxis during laparoscopic cholecystectomy (LC) is based on elective procedures and does not take into account these factors. The aim of this study was to assess the effectiveness of a selective antibiotic prophylaxis policy limited to high risk patients undergoing LC with the development of port site infections as the primary endpoint. METHODS One hundred consecutive patients undergoing LC under the care of a single consultant surgeon during a one-year period were studied prospectively. Data collected included patient demographics (age, sex) as well as details of the history of gallstone disease to determine those with complex disease and risk factors for bactibilia. A single dose of antibiotics (second generation cephalosporin and metronidazole) was administered on induction to patients with a risk factor present. Information relating to all radiologically or microbiologically confirmed infections was documented. RESULTS Eighty-four of the patients were female and the mean age was 47.7 ±16.0 years. Nineteen LCs were performed as emergencies and the remainder were elective procedures. A risk factor for bactibilia was present in 35 patients. A wound infection was identified in four cases, two of which were Staphylococcus aureus (one methicillin resistant), one was a coagulase negative Staphylococcus and one wound cultured a mixed anaerobic growth. Three of the infections occurred in patients receiving prophylaxis (2 staphylococcal and 1 anaerobic) at intervals of 7, 14 and 19 days respectively. One patient with a body mass index of 32kg/m 2 in the 'no prophylaxis' group developed a coagulase negative staphylococcal infection at 10 days. No intra or extra-abdominal abdominal infections were identified. CONCLUSIONS This study has demonstrated that restricting antibiotic prophylaxis to high risk patients has no detrimental effects in terms of increasing the rate of infections in those with no risk factors. Furthermore, the act of not prescribing to low risk patients will limit costs and the risk of adverse events. It will also reduce the risk of resistance and clostridial infections in this cohort.

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“…Имеются сообщения зарубежных авторов об от-сутствии влияния умбиликальной флоры и микро-биологических свойств желчи на частоту развития послеоперационных раневых осложнений [77,103].…”

Section: рис 8 манипуляции «ловкого» мини-робота при трансгастральнunclassified

Cholecystectomy: evolution of laparoscopic approach

Михин¹,

Kuhktenko²,

Доронин³

2015

Endosk. khir.

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Infections and bacteriological data after laparoscopic and open gallbladder surgery

Cited by 78 publications

References 20 publications

Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications

Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications

A selective antibiotic prophylaxis policy for laparoscopic cholecystectomy is effective in minimising infective complications

Cholecystectomy: evolution of laparoscopic approach

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