Abstract
Introduction: Laparoscopic cholecystectomy
is considered as the gold standard treatment for
gallstone disease. There has remained a controversy
on use of peri operative prophylactic antibiotics
during laparoscopic cholecystectomy in reducing
perioperative prophylaxis surgical site infections.
Various studies has been done to evaluate whether
single dose/ three doses or multiple doses are needed
to decrease the incidence of surgical site infections.
The objective of this study was to identify the
incidence of postoperative surgical site infections
with three doses of perioperative antibiotics after
laparoscopic cholecystectomy.
Materials and Methods: This is a retrospective
observational study conducted at a private hospital
from November 2017 to March 2020. All the
patients received three doses of ceftriaxone 1 gram
within the first 24 hours of surgery. The incidence
of surgical site infection was noted.
Results: A total of 449 patients who fulfilled the
inclusion criteria were studied. The age ranged from
16 to 88 years. Male to female ratio was 1:4. Seven
cases (1.55%) developed postoperative surgical site
infections.
Conclusion: Three doses of perioperative antibiotics
are recommended in laparoscopic cholecystectomy
to prevent postoperative surgical site infections.
References
after clinical introduction, World Journal of
Surgery 30:7(2006)1190-203
2. Stinton LM, Shaffer EA. Epidemiology of
Gallbladder Disease: Cholelithiasis and
Cancer. Gut Liver. 2012;6(2);172-187
3. Lujan JA, Parilla P. Robles R, Marin P,
Torralba JA, Ayllon JG. Laparoscopic vs
open cholecystectomy in the treatment of
acute cholecystitis. 1998;133(2): 173-5.
4. Eldar S, Sabo E, Nash E, Abrahamson
J, Matter I. Laparoscopic vsrsus open
cholecystectomy in acute cholecystitis. Surg
Laparosc Endosc. 1997;7(5):407-14
5. Sawyers JL. Current status of conventional
(open)cholecystectomy versus laparoscopic
cholecystectomy. Annals of Surgery.
1996;223(1):1-3
6. Lippert H.Gastingerj. Antimicrobial
prophylaxis in laparoscopic and
conventional cholecystectomy. Conclusions
of a large prospective multicenter
quality assurance study in Germany
chemotherapy.1998;44:355-63
7. Clarke JS, Condon RE, Bartlett JG, Gorbach
SL, Nichols RL,Ochi S, Preoperative oral
antibiotics reduce septic complications of
colon operations results of prospective ,
randomized, double blind clinical study.
Ann Surg 1977;186(3):251-9
8. Koirala A, Thakur D, Agrawal S, Chaudhary
BL. Single dose versus multiple dose
antibiotics in laparoscopic cholecystectomy:
A prospective comparative blind study.
Journal of Society of Anaesthesiologists of
Nepal(JSAN)2018;5(1):11-15
9. Yogendra D. Shah, Pukur I.Thekdi, Soham
Raut, K.G. Patel;Single shot versus multiple
shot antibiotic therapy in patients undergoing
laparoscopic surgery:our experience.
International Journal of Research in Medical
Sciences.2013;1:252-256
10. Rajesh Chaudhary, Sanjeev Sharma,
Sudarshan Chaudhary, Sunil Thakur, Ankit
Shukla, Manjeet Sharma; A Prospective
Study comparing Single with Multiple
Antibiotic Prophylaxis dose in Elective
Cholecystecctomy. Annals of International
Medical and Dental Research 2015;1:29-33
11. Sutariya PK, Thekdi. Single dose versus
multiple dose prophylactic antibiotics
in laparoscopic cholecystectomy: a
comparative study. IntSurg J 2016;3:633-6
12. Sagun Bahadur Thapa, Yeshwant
Ramakrishna Kher, Yashwant Gajanan
Tambay; Single dose intraoperative
Antibiotics versus Postoperative Antibiotics
for Patient undergoing Laparoscopic
Cholecystectomy for symptomatic
Cholelithiasis: a Randomized Clinical
Trial;J. Lumbini.Med.Coll.2017;5:13-17
13. Kim SH, Yu HC, Yang JD. Ahn SW, Hwang
HP. Role of prophylactic antibiotics in
elective laparoscopic cholecystectomy: A
systematic review and meta-analysis. Ann
Hepatobiliary Pancreat Surg.2018;22:231-
247.
14. Liang B, Dai M, Zou Z. Safety and efficacy of
antibiotic prophylaxis in patients undergoing
elective laparoscopic cholecystectomy:
A systematic review and meta-analysis. J
Gastroenterol Hepatol.2016;31:921-8
15. Matsui Y, Satoi S, Hirooka S, Kosaka
H, Kawaura T, Kitawaki T. Reappraisal
of previously reported meta-analyses
on antibiotic prophylaxis for low risk
laparoscopic cholecystectomy: an overview
of systematic reviews.BMJ Open.
2018;8:e016666
16. Kakkar M, Chatterjee P, Chauhan AS, Grace
D, Lindahl J, Beeche A, Jing F, Chotinan S.
Antimicrobial resistance in South East Asia:
time to ask the right questions. Glob Health
Action.2018;11:1483637
17. Abro AH, Pathan AH, Siddiqui FG, Syed
F, Laghari AA. Single dose versus 24 hours
antibiotic prophylaxis against surgical site
infections. JLUMHS 2014;13(1):27-31
18. Matsui Y, Satoi S, Kaibori M, Toyokawa
H, Yanagimoto H, et al.(2014)
Antibiotic Prophylaxis in Laparoscopic
Cholecystectomy: A Randomized Controlled
Trial.PLos ONE 9(9):e106702 doi:10.1371/
journal.pone.0106702