Aoki Y, Tanimura H, Ohkohchi N
Department of Gastroenterological Surgery, Wakayama Medical College, Japan.
Nihon Geka Hokan. 1992 Sep 1;61(5):387-95.
Efficacy of topical antibiotics in cholecystectomy for gallstone disease was evaluated. Forty-four patients who accepted topical single administration of 1 or 2 g each of latamoxef, cefmenoxime, cefotiam or cefamandole during operation were compared with 36 patients with systemic administration of cefem antibiotics by intravenous drip at a dose of 1 or 2 g, twice daily for postoperative 4 to 7 consecutive days. In topical administration group, concentration of each antibiotic in the gallbladder and common duct bile, gallbladder tissue, parietal peritonea and intra- and postoperative peripheral blood exceeded mostly MIC80 against bacteria usually existing in bile by biliary tract infection or bacteria by wound infection. There was no difference between the two groups in postoperative clinical course. Thus, an adequate prophylactic effect can be expected by topical use of antibiotic during cholecystectomy.
评估了局部应用抗生素在胆囊结石病胆囊切除术中的疗效。将44例在手术期间接受单次局部应用拉氧头孢、头孢甲肟、头孢替安或头孢孟多各1或2 g的患者，与36例术后连续4至7天每天两次静脉滴注头孢类抗生素1或2 g进行全身给药的患者进行比较。在局部给药组中，每种抗生素在胆囊和胆总管胆汁、胆囊组织、壁层腹膜以及术中和术后外周血中的浓度大多超过了对通常存在于胆汁中的因胆道感染的细菌或伤口感染的细菌的MIC80。两组术后临床过程无差异。因此，胆囊切除术中局部应用抗生素可预期有足够的预防效果。
