Determinants of postoperative infection after laparoscopic cholecystectomy.
OBJECTIVE
The aim of this study was to evaluate the effect of antibiotic prophylaxis on the development of infectious complications in laparoscopic cholecystectomy.


METHODS
A total of 208 patients undergoing elective laparoscopic cholecystectomy were randomized, double-blinded into one of two treatment arms: 1) cefazolin 1 g intravenously after induction of anesthesia and 2) no prophylactic antibiotics. The patients were followed-up for infectious complications for 30 days at the out-patient clinic. The data collected included age, sex, body mass index, ultrasonography findings, accompanying diseases, perforation during surgery, stone spillage, operation time, port of gallbladder delivery, suture material used for skin closure, preoperative and length of postoperative hospitalization, bile culture, pathology of the gallbladder, serum biochemical findings including alanine aminotransferase, aspartate aminotransferase, gammaglutamyl transpeptidase, bilirubin, alkaline phosphatase and glucose.


RESULTS
Overall rate of infection was 3.36%. Four out of 105 patients who received antibiotics and 3 out of 103 patients who did not receive antibiotics developed infection. The difference was not statistically significant. Obesity and closing the skin with nylon sutures were found to be associated with increased rate of infectious complications.


CONCLUSIONS
Cefazolin prophylaxis in low risk patients has no effect on postoperative infection rate in laparoscopic cholecystectomy.
Yildiz
Baris
B
Hacettepe University Faculty of Medicine General Surgery Department, Ankara, Turkey. baris104@yahoo.com
Abbasoglu
Osman
O
Tirnaksiz
Bulent
B
Hamaloglu
Erhan
E
Ozdemir
Aycan
A
Sayek
Iskender
I
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D002437:Cefazolin / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D002437:Cefazolin