Department of General Surgery, Faculty of Medicine, Alanya Alaaddin Keykubat University, Alanya, Turkey.
Department of General Surgery, Başkent University Alanya Hospital, Alanya, Turkey.
J Laparoendosc Adv Surg Tech A. 2021 Jan;31(1):54-60. doi: 10.1089/lap.2020.0322. Epub 2020 Jun 26.
Iatrogenic perforation of the gallbladder during laparoscopic cholecystectomy (LC) is one of the most common intraoperative complications, and there is no clear consensus among surgeons on this issue and there are studies reporting the antibiotic treatment. The aim of this study is to determine the effect of type and duration of antibiotic use on infective complications between iatrogenic perforations of the gallbladder during LC patients. Patients who developed iatrogenic perforation of gallbladder during LC were subdivided into three groups according to antibiotic treatment; single dose intravenous (i.v.) antibiotic group, prophylactic antibiotic + additional dose i.v. antibiotic group, and prophylaxis + additional dose i.v. antibiotic + oral antibiotic group. A total of 577 patients who underwent LC were included in the study, and 114 patients (19.8%) had iatrogenic perforation of gallbladder. No statistically significant difference was found in wound infection and surgical site infection in all three groups ( > .05). We suggest that single dose antibiotic use is sufficient to prevent infectious complications in patients who had iatrogenic perforation of the gallbladder during LC. Adding intravenous and/or oral antibiotics does not contribute to prevention of infective complications in these patients.
腹腔镜胆囊切除术（LC）中胆囊医源性穿孔是最常见的术中并发症之一，对此问题外科医生之间没有明确共识，也有研究报告抗生素治疗。本研究旨在确定抗生素的类型和使用时间对 LC 患者胆囊医源性穿孔感染性并发症的影响。 根据抗生素治疗情况，将发生 LC 时胆囊医源性穿孔的患者分为三组：单次静脉（i.v.）抗生素组、预防性抗生素+额外剂量 i.v.抗生素组和预防+额外剂量 i.v.抗生素+口服抗生素组。 共有 577 例患者接受了 LC，114 例（19.8%）患者发生了胆囊医源性穿孔。三组患者的伤口感染和手术部位感染均无统计学差异（> 0.05）。 我们建议，对于 LC 时发生胆囊医源性穿孔的患者，单次使用抗生素即可预防感染性并发症。在这些患者中，额外使用静脉和/或口服抗生素并不能预防感染性并发症。
