Prevention of Postoperative Infection Following Laparoscopic Cholecystectomy -Comparison between Single Dose and 2-day Dose Administration of Antibiotic Prophylaxis-

Yasuki Unemura, Yuichi Ishida, Yukio Nakabayashi, Hitoshi Yamadera, Masahiko Ohtsuka, Satoko Nakono, Takeyuki Misawa, Katsuyuki Hashimoto, Susumu Kobayashi and Yoji Yamazaki

The Jikei University School of Medicine Department of Surgery

We conducted a prospective randomized trial to compare single-dose antibiotic administration to 2-day dose administration in 242 patients undergoing elective laparoscopic cholecystectomy with a low risk for postoperative infection. We found no statistically significant difference between single- and 2-day dose groups, except that operating time was slightly longer in the 2-day dose group. Postoperative infection was 1.7% in the single-dose group and 3.3% in the 2-day group. Infection site was one of portsite wounds among all cases with postoperative infection, and no nonsurgical-site infection was seen. No statistically significant difference was seen between groups in white blood cell or granulocyte count, CRP on first postoperative day, or postoperative hospital stay length. Findings from cultures of bile samples were positive in 9.9%, statistically higher in patients having gallbladder stones. No significant difference was seen between microbial-positive group and negative groups in postoperative infection. Almost 30% of detected microbial resisted the administered drug. We concluded that single-dose preoperative antibiotic prophylaxis was justifiable in cases of laparoscopic cholecystectomy with a low risk of postoperative infection.

Key words
laparoscopic cholecystectomy, postoperative infection, surgical site infection, antibiotic prophylaxis

Reprint requests
Yasuki Unemura Department of Surgery, The Jikei University School of Medicine 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461 JAPAN

Accepted
September 20, 2000

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