title: Does using a laparoscopic approach to cholecystectomy decrease the risk of surgical site infection?
abstract: OBJECTIVE
  To assess the impact of laparoscopy on surgical site infections (SSIs) following cholecystectomy in a large population of patients.
  
  
  BACKGROUND
  Previous investigations have demonstrated that laparoscopic cholecystectomy is associated with a shorter postoperative stay and fewer overall complications. Less is known about the impact of laparoscopy on the risk for SSIs.
  
  
  METHODS
  Epidemiologic analysis was performed on data collected during a 7-year period (1992-1999) by participating hospitals in the National Nosocomial Infections Surveillance (NNIS) System in the United States.
  
  
  RESULTS
  For 54,504 inpatient cholecystectomy procedures reported, use of the laparoscopic technique increased from 59% in 1992 to 79% in 1999. The overall rate of SSI was significantly lower for laparoscopic cholecystectomy than for open cholecystectomy. Overall, infecting organisms were similar for both approaches. Even after controlling for other significant factors, the risk for SSI was lower in patients undergoing the laparoscopic technique than the open technique.
  
  
  CONCLUSIONS
  Laparoscopic cholecystectomy is associated with a lower risk for SSI than open cholecystectomy, even after adjusting for other risk factors. For interhospital comparisons, SSI rates following cholecystectomy should be stratified by the type of technique.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. cir6@cdc.gov
authors.forename: Chesley
authors.initials: C
authors.lastname: Richards
authors.forename: Jonathan
authors.initials: J
authors.lastname: Edwards
authors.forename: David
authors.initials: D
authors.lastname: Culver
authors.forename: T Grace
authors.initials: TG
authors.lastname: Emori
authors.forename: James
authors.initials: J
authors.lastname: Tolson
authors.forename: Robert
authors.initials: R
authors.lastname: Gaynes
mesh_terms: D002763:Cholecystectomy / Q000009:adverse effects; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D003428:Cross Infection / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000382:microbiology