title: The role of prophylactic antibiotics on surgical site infection in elective laparoscopic cholecystectomy.
abstract: OBJECTIVE
  Although laparoscopic cholecystectomy is a common and widely accepted technique, the use of prophylactic antibiotics in elective laparoscopic cholecystectomy still remains controversial. The aim of this study is to determine whether prophylactic antibiotics could prevent surgical site infection after elective laparoscopic cholecystectomy and to identify any risk factors for surgical site infection.
  
  
  METHODS
  This study included 471 patients undergoing laparoscopic cholecystectomy between January 2009 and May 2012. Period 1 patients (279) received second generation cephalosporin 1 g intravenously after induction of anesthesia, and Period 2 patients (192) were not given prophylactic antibiotics. The characteristics and surgical site infections of the patients were compared and analyzed.
  
  
  RESULTS
  The overall rate of surgical site infection was 1.69% for the total of 471 patients. The incidence of surgical site infection was similar for the two Periods: 5 of 279 patients (1.79%) in Period 1, 3 of 192 patients (1.56%) in Period 2 (p=0.973). All of the patients with surgical site infections were well treated under conservative treatments without any sequelae. The preoperative albumin level (p=0.023) contributed to surgical site infection.
  
  
  CONCLUSIONS
  Prophylactic antibiotics are not necessary for elective laparoscopic cholecystectomy but patients in poor nutritional state with low albumin level should consider prophylactic antibiotics.
authors.affiliation: Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jae Uk
authors.initials: JU
authors.lastname: Chong
authors.affiliation: Department of Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jee Ye
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kim
keywords: Antibiotic prophylaxis; Laparoscopic cholecystectomy; Nutrition assessment; Surgical wound infection