title: Effect of cefazolin prophylaxis on postoperative infectious complications in elective laparoscopic cholecystectomy: a prospective randomized study.
abstract: BACKGROUND
  In patients with symptomatic cholelithiasis, laparoscopic cholecystectomy (LC) is the standard method of treatment. Laparoscopic cholecystectomy has a low rate of postoperative infections probably owing to smaller wounds and minimal tissue damage compared with the open procedure.
  
  
  OBJECTIVE
  This study assessed the effect of cefazolin prophylaxis on postoperative infection in patients undergoing elective laparoscopic cholecystectomy. Additionally, we determined the risk factors of cases with postoperative infection.
  
  
  METHODS
  A total of 753 patients were enrolled in the study. Among these, 206 were excluded from the study. As a result, 547 patients with symptomatic cholelithiasis who underwent elective laparoscopic cholecystectomy were selected for this prospective study. Patients were randomized consecutively and divided into 2 groups: patients in the cefazolin (CEF) group (n = 278) received 1 g of cefazolin and those in the control group (n = 269) received 10 mL of isotonic sodium chloride solution. Patient characteristics and overall surgical outcomes were compared between the groups. All patients were followed for development of postoperative infections.
  
  
  RESULTS
  Postoperative infections occurred in 4 patients in the CEF group and in 2 patients in the control group; no significant difference existed in this regard(P = .44). Risk of infection increased in patients with previous cholecystitis and/or endoscopic retrograde cholangiopancreatography (P < 0.001), patients with ruptured gallbladders, and patients for whom a suction drain was used (respectively, P < 0.001 and P < 0.001).
  
  
  CONCLUSIONS
  No correlation existed between cefazolin prophylaxis and postoperative infections in elective laparoscopic cholecystectomy patients. There may be an increased risk of infection in patients with previous cholecystitis or endoscopic retrograde cholangiopancreatography. In addition, there was an increased risk of postoperative infection in patients with gallbladder rupture and suction drain use.
authors.affiliation: Department of Surgery, Baskent University, Ankara, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Turk
authors.affiliation: Department of Surgery, Baskent University, Ankara, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Karagulle
authors.affiliation: Infectious Diseases and Clinical Microbiology, Baskent University, Ankara, Turkey.
authors.forename: Kivanc
authors.initials: K
authors.lastname: Serefhanoglu
authors.affiliation: Infectious Diseases and Clinical Microbiology, Baskent University, Ankara, Turkey.
authors.forename: Hale
authors.initials: H
authors.lastname: Turan
authors.affiliation: Department of Surgery, Baskent University, Ankara, Turkey.
authors.forename: Gokhan
authors.initials: G
authors.lastname: Moray
keywords: Antibiotic Prophylaxis; Cholecystectomy, Laparoscopic; Surgical Wound Infection