title: Clinical outcomes of laparoscopic cholecystectomy with accidental gallbladder perforation.
abstract: BACKGROUND
  Accidental gallbladder perforation frequently occurs during laparoscopic cholecystectomy and may increase the risk of infection. However, the necessity of antimicrobial prophylaxis for these patients is unclear. The aim of this study was to examine the clinical outcomes and necessity of antimicrobial prophylaxis after laparoscopic cholecystectomy with gallbladder perforation.
  
  
  METHODS
  One hundred patients who underwent laparoscopic cholecystectomy were divided into two groups: patients with gallbladder perforation (Group A, n = 37) and patients without perforation (Group B, n = 63). We compared the white blood cell count and C-reactive protein level the day after the operation, the complication rates of systemic inflammatory response syndrome and surgical-site infection, and postoperative hospital stay between the two groups. All patients received antimicrobial prophylaxis only once before the operation.
  
  
  RESULTS
  There were significant differences in every variable with the exception of postoperative hospital stay. Group A had a higher risk of infection, but the postoperative clinical course of Group A was not inferior to that of Group B.
  
  
  CONCLUSIONS
  The clinical outcomes of patients with accidental gallbladder perforation were acceptable, and the use of antimicrobial prophylaxis once before the operation was sufficient.
authors.affiliation: Department of Surgery, Machida Municipal Hospital, Tokyo, Japan.
authors.forename: Teruyuki
authors.identifier: http://orcid.org/0000-0003-3404-1145
authors.initials: T
authors.lastname: Usuba
authors.affiliation: Department of Surgery, Machida Municipal Hospital, Tokyo, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nyumura
authors.affiliation: Department of Surgery, Machida Municipal Hospital, Tokyo, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Takano
authors.affiliation: Department of Surgery, Machida Municipal Hospital, Tokyo, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Iino
authors.affiliation: Department of Surgery, Machida Municipal Hospital, Tokyo, Japan.
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Hanyu
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D005260:Female; D005704:Gallbladder / Q000293:injuries*; D005705:Gallbladder Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000453:epidemiology*; D018746:Systemic Inflammatory Response Syndrome / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002097:C-Reactive Protein
keywords: Antimicrobial prophylaxis; gallbladder perforation; laparoscopic cholecystectomy