Today, laparoscopic cholecystectomy is rapidly replacing traditional c
holecystectomy as the standard treatment of symptomatic cholelithiasis
in children. We reviewed the bile cultures and postoperative course o
f 30 children who underwent laparoscopic cholecystectomy with the aim
of establishing a routine policy for perioperative antibiotic treatmen
t and for the management of biliary leak during that procedure. A posi
tive bile culture was found in only one child (Salmonella Group D). Al
l patients, including six children with intraoperative bile spillage,
had a completely normal and uneventful postoperative course. We conclu
ded that the use of preoperative antibiotic treatment should be limite
d in laparoscopic cholecystectomy in children and is probably not requ
ired at all, awaiting proof from a further study. The present study fu
rther showed that intraoperative bile spillage is of no clinical signi
ficance and can be treated simply with local saline irrigation during
the laparoscopic procedure.