Infection after laparoscopic cholecystectomy: are antibiotics really necessary?

OBJECTIVE

To establish the incidence of infection after laparoscopic cholecystectomy, and assess the need for antibiotic prophylaxis.

DESIGN

Prospective open study.

SETTING

University teaching hospital, United Kingdom.

SUBJECTS

253 consecutive patients undergoing laparoscopic cholecystectomy between September 1990 and January 1993.

INTERVENTIONS

A single intravenous dose of cefuroxime 1.5 g at induction of general anaesthesia.

MAIN OUTCOME MEASURES

Infective complications.

RESULTS

Patients were reviewed at two weeks and 12 months. At two weeks there had been two wound infections (one resolved spontaneously and the other required removal of a gallstone from the subcutaneous tissue), two chest infections (treated with antibiotics orally and physiotherapy), and one subhepatic abscess (drained percutaneously under ultrasonographic control). No other complications were reported at 12 months.

CONCLUSIONS

Routine antibiotic prophylaxis may be unnecessary during elective laparoscopic cholecystectomy, but a randomised controlled trial is necessary to confirm this.