Uludag Mehmet, Yetkin Gurkan, Citgez Bulent
Second Department of General Surgery, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
JSLS. 2009 Jul-Sep;13(3):337-41.
Elective laparoscopic cholecystectomy has a low risk for infectious complications, but many surgeons still use prophylactic antibiotics. The aim of this prospective study was to investigate the necessity and test the efficacy of prophylactic antibiotics on postoperative infection complications in low-risk patients undergoing laparoscopic cholecystectomy.
Low-risk patients were randomly placed into 2 groups: 68 patients (group 1) received cefazolin 1g intravenously after induction of anesthesia, and 76 patients (group 2) were not given prophylactic antibiotics. In both groups, septic complications were recorded and compared.
Positive bile culture and gallbladder rupture did not significantly increase the rate of surgical site infections. In group 1, there were 3 (4.41%) cases of wound infection, 3 (4.41%) cases of pulmonary infections, and 1 (1.47%) case of urinary tract infection. In group 2, there were 2 (2.63%) cases of wound infection, 2 (2.63%) case of pulmonary infections, and 3 (3.95%) cases of urinary tract infection. No significant difference existed in the complication rates.
Based on our data, the use of prophylactic antibiotics does not decrease the rate of postoperative infection complications and surgical-site infections and is not necessary in low-risk patients undergoing laparoscopic cholecystectomy.
择期腹腔镜胆囊切除术发生感染并发症的风险较低，但许多外科医生仍使用预防性抗生素。这项前瞻性研究的目的是调查低风险腹腔镜胆囊切除术患者使用预防性抗生素预防术后感染并发症的必要性并检验其疗效。
将低风险患者随机分为两组：68例患者（第1组）在麻醉诱导后静脉注射1g头孢唑林，76例患者（第2组）未使用预防性抗生素。记录并比较两组的感染并发症情况。
胆汁培养阳性和胆囊破裂并未显著增加手术部位感染率。第1组有3例（4.41%）伤口感染、3例（4.41%）肺部感染和1例（1.47%）尿路感染。第2组有2例（2.63%）伤口感染、2例（2.63%）肺部感染和3例（3.95%）尿路感染。并发症发生率无显著差异。
根据我们的数据，预防性使用抗生素并不能降低术后感染并发症和手术部位感染的发生率，对于低风险腹腔镜胆囊切除术患者而言并无必要。
