Role of Prophylactic Antibiotic in Elective Laparoscopic Cholecystectomy

Hassan, Ahmed Mohamed Abdelaziz; Nasr, Magid Mahmoud; Hamdy, Hosam Eldien; Abbas, Mohamed; Hedaya, Mohammed Saied; Elsebae, Magdy M.A.

doi:10.12816/0006301

Cited by 10 publications

(18 citation statements)

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“…In RCTs, only 12 studies212228323638404243444547 showed the data from intention-to-treat analysis, and the other 16 studies20232425262729303133343537394146 showed data from per-protocol analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Subgroup analysis for SSI including both superficial and deep SSI was performed using 28 RCTs,20212223242526272829303132333435363738394041424344454647 3 prospective studies,484950 and 3 retrospective studies 225152. In the 28 RCTs, 83 (2.07%) of the 4018 patients in the prophylactic antibiotic group developed SSI compared with 119 (3.17%) of the 3752 patients in the no prophylaxis group.…”

Section: Resultsmentioning

confidence: 99%

“…Jadad et al19 score was also applied to assess the quality of included randomized studies in the meta-analysis. Of the 28 RCTs,20212223242526272829303132333435363738394041424344454647 25 studies22232425262728293031323334353637394041424344454647 were eligible to be included in the meta-analysis with high-quality Jadad score ≥3, and the other 3 studies202138 were low-quality studies with Jadad score 2. Sensitivity tests were performed to assess whether including three RCTs classified as low-quality is appropriate in this meta-analysis.…”

Section: Methodsmentioning

confidence: 99%

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Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Kim

Yang

et al. 2018

Ann Hepatobiliary Pancreat Surg

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Backgrounds/AimsThe role of prophylactic antibiotics for laparoscopic cholecystectomy in low-risk patients is still unclear. This study aimed to verify the conclusion of previous meta-analyses concerning the effectiveness of antibiotic prophylaxis for elective laparoscopic cholecystectomy in low-risk patients.MethodsComprehensive literature searches were performed on electric databases and manual searches. Randomized controlled trials (RCTs), prospective studies, and retrospective studies comparing antibiotic prophylaxis to placebo or no antibiotics in low-risk elective laparoscopic cholecystectomy were included.ResultsThis study included 28 RCTs, three prospective studies, and three retrospective studies. In RCTs, prophylactic antibiotics did not prevent deep surgical site infections (SSI) (RR 1.10, 95% confidence interval [CI] [0.45–2.69], p=0.84) but reduced SSI (RR 0.70, 95% CI [0.53–0.94], p=0.02), and superficial SSI (RR 0.58, 95% CI [0.42–0.82], p=0.01). Prospective studies showed prophylactic antibiotics did not reduce superficial SSI (RR 0.35, 95% CI [0.01–8.40], p=0.52) but reduced SSI (RR 0.12, 95% CI [0.04–0.35], p=0.0001). In retrospective studies, antibiotic prophylaxis did not reduce SSI (RR 1.59, 95% CI [0.30–8.32], p=0.58). The pooled data (12121 patients) including RCTs and prospective and retrospective studies showed that prophylactic antibiotics were not effective in preventing deep SSI (RR 1.01 95% CI [0.46–2.21], p=0.98) but effective in reducing SSI (RR 0.67, 95% CI [0.51–0.88], p=0.003) and superficial SSI (RR 0.61, 95% CI [0.45–0.83], p=0.002).ConclusionsThe use of prophylactic antibiotics is effective for reducing the incidence of SSI and superficial SSI but is not effective for preventing deep SSI in low-risk patients who underwent elective laparoscopic cholecystectomy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Kim

Yang

et al. 2018

Ann Hepatobiliary Pancreat Surg

View full text Add to dashboard Cite

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“…It is not possible to assess the exact cause of SSI in the cases of cholecystectomy because there is no significant difference in the infection rate in the prophylactic and non-prophylactic groups. 21 Low-risk patients were defined as those who did not have acute cholecystitis, a recent history of acute cholecystitis, common bile duct calculi, jaundice, immune suppression, or prosthetic implants. 22 As patients converted to OC, with a history of previous biliary surgery, age > 60 years, and bile spillage were reported to be at higher risk of post-operative infections, [23][24][25][26][27] low risk patients should be also defined as those without any of these risk factors.…”

Section: Discussionmentioning

confidence: 99%

The Role of Prophylactic Antibiotics in Patients Undergoing Elective Cholecystectomy- A Randomised Placebo Controlled Recipient Blind Trial

Basu¹,

Sarkar²,

Chaudhury³

et al. 2017

jemds

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BACKGROUNDLaparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis. The incidence of infectious complications after LC is significantly lower compared with infections with open cholecystectomy. 1,2 Antibiotic prophylaxis may not be necessary in low-risk patients undergoing elective LC. 6-10 On the contrary, many other surgeons still use and recommend the administration of prophylactic antibiotics. [11][12][13][14][15] The aim of this study is to determine the necessity of prophylactic antibiotics in preventing the postoperative infective complications in patients undergoing elective laparoscopic cholecystectomy.

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“…[19] It is not possible to assess the exact cause of SSI in the cases of cholecystectomy because there is no significant difference in the infection rate in the prophylactic and non prophylactic groups. [20]…”

Section: Discussionmentioning

confidence: 99%

Role of antibiotics on surgical site infection in cases of open and laparoscopic cholecystectomy: A comparative observational study

Gharde

Swarnkar

Waghmare

et al. 2014

J Surg Tech Case Report

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Introduction:Surgical site infection (SSI) comes as third most common healthcare related infection which produces morbidity and deaths at large. Still many authors believe that it is better not to use prophylactic antibiotics in simple and uncomplicated cases. Laparoscope, now-a-days is a much used instrument for abdominal surgeries. Even after new aseptic techniques SSI remains to be a major problem.Aims and Objectives:To study the effect of antibiotics on superficial SSI in the cases of open and laparoscopic cholecystectomy.Observation and Results:One hundred patients were enrolled for cholecystectomy. The patients were divided into two groups, A and B. Group A consisted of patients in whom laparoscopic cholecystectomy was done and group B in whom open cholecystectomy was done. The male female ratio was 1: 2.23. The mean age of patients in Group A was 46 years and in Group B was 44; Standard deviation (SD) for age was 14.8% and 13.8% in groups A and B respectively; t-value was 0.654 and P value was 0.515 and they were not significant. The number of males and females was 16 and 26 respectively in Group A and 11 and 31 in Group B. The Chi square X2 = 1.36 and P value was 0.248 and both were insignificant. The rate of superficial surgical site infection was 2.63% in both the groups.Conclusion:Our study concludes that there is no difference in the outcome of patients in cases of open as well as laparoscopic cholecystectomy. There is no significant difference in the surgical site infection rate in cases of open as well as laparoscopic cholecystectomy.

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Role of Prophylactic Antibiotic in Elective Laparoscopic Cholecystectomy

Cited by 10 publications

References 0 publications

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

Role of prophylactic antibiotics in elective laparoscopic cholecystectomy: A systematic review and meta-analysis

The Role of Prophylactic Antibiotics in Patients Undergoing Elective Cholecystectomy- A Randomised Placebo Controlled Recipient Blind Trial

Role of antibiotics on surgical site infection in cases of open and laparoscopic cholecystectomy: A comparative observational study

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