Does using a laparoscopic approach to cholecystectomy decrease the risk of surgical site infection?
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.
Richards
Chesley
C
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. cir6@cdc.gov
Edwards
Jonathan
J
Culver
David
D
Emori
T Grace
TG
Tolson
James
J
Gaynes
Robert
R
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