Hell K
Zentralbl Chir. 1998;123 Suppl 2:37-41.
The effectiveness of antimicrobial prophylaxis was evaluated on the basis of data collected in a study on quality management carried out in 28 East German hospitals, involving 4477 laparoscopic and conventional cholecystectomies (197 of which with revision of the common bile duct). In 3128 patients a laparoscopic procedure (with consecutive conversion to an open cholecystectomy in 236 cases) and in 1349 patients a primarily conventional open cholecystectomy had been performed (a total of 2217 cases with and 2260 cases without antibiotic cover). The results obtained were significantly better in the group receiving prophylaxis than in patients not under antimicrobial cover. This applied to septic wound healing disorders, general and specific postoperative complications, postoperative chest infections, re-operations and postoperative lethality. On the basis of these results, it is strongly recommended that, in the future, neither laparoscopic nor open conventional cholecystectomy should be carried out without proper perioperative antimicrobial prophylaxis-this all the more so since such measures also result in a shorter hospital stay and thus reduced costs.
基于在东德28家医院开展的质量管理研究中收集的数据，评估了抗菌预防的效果。该研究涉及4477例腹腔镜胆囊切除术和传统胆囊切除术（其中197例进行了胆总管修复）。3128例患者接受了腹腔镜手术（236例随后转为开腹胆囊切除术），1349例患者接受了主要为传统的开腹胆囊切除术（总共2217例使用抗生素预防，2260例未使用）。接受预防措施组的结果明显优于未接受抗菌预防的患者。这适用于感染性伤口愈合障碍、一般和特定的术后并发症、术后肺部感染、再次手术和术后死亡率。基于这些结果，强烈建议今后无论是腹腔镜胆囊切除术还是传统开腹胆囊切除术，若无适当的围手术期抗菌预防措施均不应进行——尤其如此，因为这些措施还可缩短住院时间，从而降低成本。
