A Prospective Clinical Study On Gallbladder Bile Bacteria And Perioperative Use Of Prophylactic Antibiotics In Elective Laparoscopic Cholecystectomy

Objective:To investigate prospectively the perioperative use of prophylactic antibiotics in low-risk elective laparoscopic cholecystectormy.Methods:150 patients undergoing elective laparoscopic cholecystctomy were randomized into 1 of 3 treatment arms:Group A(50 patients) received no prophylactic antibiotics,Group B (50 patients) received a single intravenous dose of ceftriaxone 2g at induction of general anesthesia,Group C(50 patients)received postoperatively a total of three 2g doses of intraveneous ceftriaxone.Postoperative wound infection,intra-abdominal infection or abscess, pneumonia and lower urinary tract infection were compared with each other.Results:146 patients were performed successfully under laparoscopy and four cases were converted to open cholecystectomy.The conversion cases were excluded from the statistical analysis:lcase from group A.1 case from group B and 2 cases from group C.Group A(49 patients) had 1 superficial surgical site infection and 1 lower urinary tract infection with a 2% wound infection rate and an overall infection rate of 4.1%;Group B(49 patients) had 1 superficial surgical site infection and 1 postoperative pneumonia with a 2%wound infection rate and 2 low urinary tract infection with a 4.1%wound infection rate and an overall infection rate of 8.2%;Group C(48 patients) had 2 superficial surgical site infection and 2 postoperative pneumonia with a 4%wound infection rate and 1 lower urinary tract infection with a 2.1% wound infection rate and an overall infection rate of 10%.All patients were followed-up for 3-12months.There were no intra-abdominal infection and abscess.Comparison of the above data shows no statistically significant difference between the three groups for wound infection, intra-abdominal infection,postoperative pneumonia,lower urinary tract infection and overall infection.Conclusion:Low-risk elective laparoscopic cholecystectomy carries a low risk of wound infection and the other infections.No use of prophylactic antibiotics does not increase the rate of postoperative infection in low-risk elective laparoscopic cholecystectomy.