title: Effect of bag extraction to prevent wound infection on umbilical port site wound on elective laparoscopic cholecystectomy: a prospective randomised clinical trial.
abstract: Laparoscopic cholecystectomy is the gold standard treatment for gallbladder stones. Complications due to laparoscopic procedure are rare, but rate of wound infection in some studies is about 8 %. From January 2007 to December 2008, 320 laparoscopic cholecystectomies were performed at our hospital, and in 4.7 % of them, wound infection of the umbilical trocar was identified. We believe that this infection rate could be lower and that it is necessary to implement a new technique to reduce the wound infection. The aim of the study was to evaluate the benefits of bag extraction of gallbladder to prevent the wound infection.
  
  
  
  Two-arm, parallel, 1:1, randomised controlled trial (ISRCTN38095251). All patients suffering from symptomatic gallbladder stones of low risk were enrolled for this study and were divided into two groups in basics gallbladder extraction: with (80 patients) or, as usually, without bag (76 patients). All patients with cholecystitis or accidental gallbladder perforation were excluded. We compared all the results to establish whether meaningful differences were found.
  
  
  
  The final sample analysed (156 patients) consisted of 121 women and 35 men; there were 80 in the control group and 76 in the study group. There were 15 (9.6 %) diagnosed wound infections, eight cases in the study group and seven in the control group. There were no statistically significant differences.
  
  
  
  The determinant of wound infection in elective laparoscopic cholecystectomy is not the direct contact of the gallbladder with the wound; therefore, bag extraction is not necessary.
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, C/Camí Vell de la Colònia 25, 08830, Sant Boi de Llobregat, Barcelona, Spain. j.comajuncosas@pssjd.org.
authors.forename: Jordi
authors.initials: J
authors.lastname: Comajuncosas
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, C/Camí Vell de la Colònia 25, 08830, Sant Boi de Llobregat, Barcelona, Spain.
authors.forename: Judit
authors.initials: J
authors.lastname: Hermoso
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, C/Camí Vell de la Colònia 25, 08830, Sant Boi de Llobregat, Barcelona, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: Jimeno
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, C/Camí Vell de la Colònia 25, 08830, Sant Boi de Llobregat, Barcelona, Spain.
authors.forename: Pere
authors.initials: P
authors.lastname: Gris
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, C/Camí Vell de la Colònia 25, 08830, Sant Boi de Llobregat, Barcelona, Spain.
authors.forename: Rolando
authors.initials: R
authors.lastname: Orbeal
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, C/Camí Vell de la Colònia 25, 08830, Sant Boi de Llobregat, Barcelona, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Cruz
authors.affiliation: Department of General and Digestive Surgery, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, C/Camí Vell de la Colònia 25, 08830, Sant Boi de Llobregat, Barcelona, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Parés
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002764:Cholecystitis / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000517:prevention & control*
keywords: Bag extraction; Gallbladder; Laparoscopic cholecystectomy; Laparoscopic complications; Trocar site incisional hernia; Wound infection