A Gaur1, A K Pujahari2. 1. Resident, Command Hospital (AF), Bangalore-07. 2. Senior Advisor (Surgery), Command Hospital (AF), Bangalore-07.
Abstract
BACKGROUND:Antibiotic prophylaxis is routinely administered in laparoscopic cholecystetomy but its role is debatable. METHODS:From January 2004 to August 2008, 417 patients were randomized into 208 in antibiotic group (AG) and 209 in non antibiotic group (NAG). AG received one dose each of injection ciprofloxacin (200 mg) and metronidazole (500mg) preoperatively. NAG was given only intravenous fluids. Besides routine care, all underwent abdominal sonography and liver function tests at least once during the 30 postoperative days. RESULT: Age, sex and co-morbidity distribution were similar in both the groups. One patient who was on weekly 5mg methotraxate (NAG) had erythema around umbilical port. Other three having umbilical discharge recovered without antibiotics. Nine patients had subhepatic collection (5 AG and 4 NAG). One from NAG underwent re-laparoscopy and drainage. Ten patients had fever. Two from AG had basal lung collapse and were given antibiotics. CONCLUSION:Antibiotic prophylaxis is not needed for laparoscopic cholecystectomy.
RCT Entities:
BACKGROUND: Antibiotic prophylaxis is routinely administered in laparoscopic cholecystetomy but its role is debatable. METHODS: From January 2004 to August 2008, 417 patients were randomized into 208 in antibiotic group (AG) and 209 in non antibiotic group (NAG). AG received one dose each of injection ciprofloxacin (200 mg) and metronidazole (500mg) preoperatively. NAG was given only intravenous fluids. Besides routine care, all underwent abdominal sonography and liver function tests at least once during the 30 postoperative days. RESULT: Age, sex and co-morbidity distribution were similar in both the groups. One patient who was on weekly 5mg methotraxate (NAG) had erythema around umbilical port. Other three having umbilical discharge recovered without antibiotics. Nine patients had subhepatic collection (5 AG and 4 NAG). One from NAG underwent re-laparoscopy and drainage. Ten patients had fever. Two from AG had basal lung collapse and were given antibiotics. CONCLUSION: Antibiotic prophylaxis is not needed for laparoscopic cholecystectomy.
Authors: Chesley Richards; Jonathan Edwards; David Culver; T Grace Emori; James Tolson; Robert Gaynes Journal: Ann Surg Date: 2003-03 Impact factor: 12.969