INFECTION AFTER LAPAROSCOPIC CHOLECYSTECTOMY - ARE ANTIBIOTICS REALLYNECESSARY

Objective: To establish the incidence of infection after laparoscopic cholecystectomy, and assess the need for antibiotic prophylaxis. Desig n: Prospective open study. Setting: University teaching hospital, Unit ed Kingdom. Subjects: 253 consecutive patients undergoing laparoscopic cholecystectomy between September 1990 and January 1993. Intervention s: A single intravenous dose of cefuroxime 1.5 g at induction of gener al anaesthesia. Main outcome measures: Infective complications. Result s: Patients were reviewed at two weeks and 12 months. At two weeks the re had been two wound infections (one resolved spontaneously and the o ther required removal of a gallstone from the subcutaneous tissue), tw o chest infections (treated with antibiotics orally and physiotherapy) , and one subhepatic abscess (drained percutaneously under ultrasonogr aphic control). No other complications were reported at 12 months. Con clusions: Routine antibiotic prophylaxis may be unnecessary during ele ctive laparoscopic cholecystectomy, but a randomised controlled trial is necessary to confirm this.