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Is Antibiotic Therapy Necessary after Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?

Year 2022, Volume: 13 Issue: 3, 360 - 365, 27.09.2022
https://doi.org/10.18663/tjcl.1131853

Abstract

Amaç: Akut taşlı kolesistitte cerrahi alan enfeksiyonlarını önlemek için preoperatif antibiyotik tedavisi standart iken, taburcu olduktan sonra antibiyotik reçete edilmesi tartışmalıdır. Bu çalışmada taburculuk reçetesinde antibiyotik uygulamasının cerrahi alan enfeksiyonlarına etkisinin araştırılması amaçlanmıştır.
Yöntemler: Ocak 2018 ile Şubat 2020 arasında akut taşlı kolesistit nedeniyle acil laparoskopik kolesistektomi yapılan hastaların verileri geriye dönük olarak gözden geçirildi. Dekompanse sistemik hastalığı olanlar, açık kolesistektomiye dönülen vakalar, evre 3 hastalığı olanlar, açık kolesistektomi ve kolesistostomi yapılan hastalar çalışmaya dahil edilmedi. Ampisilin-sulbaktam 1 gr, ameliyattan önce ve sonra günde üç kez parenteral olarak uygulandı.
Hastalar taburculuk reçetelerine göre antibiyotik verilenler (AB grubu) ve antibiyotik verilmeyenler (NA grubu) olmak üzere iki gruba ayrıldı. Birincil sonuç, cerrahi alan enfeksiyonlarının gelişmesiydi.
Bulgular: AB grubunda 107, NA grubunda 109 hasta vardı. Toplam 29 (%13,4) hasta olmak üzere, AB grubunda 11 (%10,3) ve NA grubunda 18 (%16,5) hastada cerrahi alan enfeksiyonu gelişti. Cerrahi alan enfeksiyon oranı açısından iki grup arasında anlamlı fark bulunmadı (p>0.05). Lojistik regresyon analizinde obezite cerrahi alan enfeksiyonları için bir risk faktörüydü.
Sonuç: Laparoskopik cerrahi sonrası taburcu edilen akut taşlı kolesistit hastalarına ampisilin-sulbaktam verilmemesi cerrahi alan enfeksiyonlarını artırmaz. Ancak obez hastalara ampisilin-sulbaktam verilmesi cerrahi alan enfeksiyonlarını azaltabilir.
Anahtar Kelimeler: Cerrahi alan enfeksiyonu, akut taşlı kolesistit, acil laparoskopik kolesistektomi, obezite

References

  • Referans1. Fischer JE, ed. Mastery of surgery. 5 ed. Philadelphia: Lippincott Williams & Wilkins 2007.
  • Referans2. Duncan CB, Riall TS. Evidence-based current surgical practice: calculous gallbladder disease. J Gastrointest Surg 2012;16: 2011-25.
  • Referans3. Portincasa P, Moschetta A, Petruzzelli M, Palasciano G, Di Ciaula A, Pezzolla A. Gallstone disease: symptoms and Diagnosis of gallbladder stones. Best Pract Res Clin Gastroenterol. 2006;20: 1017–29.
  • Referans4. Attili AF, Carulli N, Roda E, Barbara B, Capocaccia L, Menotti A, Okoliksanyi L, Ricci G, Capocaccia R, Festi D, et al. Epidemiology of gallstone disease in Italy: prevalence data of the Multicenter Italian Study on Cholelithiasis (M.I.COL.). Am J Epidemiol. 1995;141: 158–65.
  • Referans5. Halldestam I, Enell EL, Kullman E, Borch K. Development of symptoms and complications in individuals with asymptomatic gallstones. Br J Surg 2004; 91: 734-738.
  • Referans6. Haisley KR, Hunter JG. Gallbladder and the Extrahepatic Biliary System. Brunicardi FC, Andersen DK, Billiar TR, editors. Schwartz’s Principles of Surgery. Eleventh Edition. New York: Mc Graw Hill;2019. pp. 1405-36.
  • Referans7. Hunter JG. Acute cholecystitis revisited: get it while it’s hot. Ann Surg. 1998;227(4):468-469.
  • Referans8. Ansaloni L, Pisano M, Coccolini F, et al. 2016 WSES guidelines on acute calculous cholecystitis. World J Emerg Surg. 2016; 11:25.
  • Referans9. Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(6):605-627. doi:10.1086/676022
  • Referans10. Mangram AJ, Horan TC, Pearson ML, et al. (1999) Guideline for Prevention of Surgical Site Infection. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 27(2): 97-132.
  • Referans11. Regimbeau JM, Fuks D, Pautrat K, Mauvais F, Haccart V, Msika S, et al. Effect of postoperative antibiotic administration on postoperative infection following cholecystectomy for acute calculous cholecystitis: a randomized clinical trial. JAMA. 2014;312:145–54.
  • Referans12. Loozen CS, Kortram K, Kornmann VN, van Ramshorst B, Vlaminckx B, Knibbe CA, et al. Randomized clinical trial of extended versus single-dose perioperative antibiotic prophylaxis for acute calculous cholecystitis. Br J Surg. 2017;104: 151–7.
  • Referans13. Yokoe M, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Gomi H, et al. TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 2013; 20: 35–46. DOI: 10.1007/s00534-012-0568-9.
  • Referans14. Gomi H, Solomkin JS, Schlossberg D, Okamoto K, Takada T, Strasberg SM, et al. Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2018; 25:3–16. DOI: 10.1002/jhbp.518. Epub 2018 Jan 9.
  • Referans15. Fuks D, Cosse C, Regimbeau JM. Antibiotic therapy in acute calculous cholecystitis. J Visc Surg 2013; Feb;150(1):3-8. doi: 10.1016/j.jviscsurg.2013.01.004.
  • Referans16. Strasberg SM. Clinical practice. Acute calculous cholecystitis. N Engl J Med 2008; 358: 2804.
  • Referans17. Solomkin JS, Mazuski JE, Bradley JS, et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Surg Infect (Larchmt). 2010 Feb;11(1):79-109. DOI: 10.1089/sur.2009.9930.
  • Referans18. Hirota M, Takada T, Kawarada Y, et al. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):78-82.
  • Referans19. Mazeh H, Mizrahi I, Dior U, et al. Role of antibiotic therapy in mild acute calculous cholecystitis: a prospective randomized controlled trial. World J Surg 2012; 36:1750-59.
  • Referans20. Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR. Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 2010;97(2):141-150.
  • Referans21. Jaafar G, Persson G, Svennblad B, Sandblom G. Outcomes of antibiotic prophylaxis in acute cholecystectomy in a population-based gallstone surgery registry. Br J Surg 2014;101:69-73. DOI: 10.1002/bjs.9369.
  • Referans22. Pierpont YN, Dinh TP, Salas RE, et al. Obesity and surgical wound healing: a current review. ISRN Obes. 2014; Feb 20;2014:638936. doi: 10.1155/2014/638936.
  • Referans23. Eming SA, Martin P, Tomic-Canic M. Wound repair and regeneration: mechanisms, signaling, and translation. Sci Transl Med. 2014; 6(265):265sr6.
  • Referans24. Alanis MC, Villers MS, Law TL, Steadman EM, Robinson CJ. Complications of cesarean delivery in the massively obese parturient. Am J Obstet Gynecol. 2010;203(3): 271.e1-271.e7.

Is Antibiotic Therapy Necessary after Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?

Year 2022, Volume: 13 Issue: 3, 360 - 365, 27.09.2022
https://doi.org/10.18663/tjcl.1131853

Abstract

Background: While preoperative antibiotic therapy is standard to prevent surgical site infections in acute calculous cholecystitis, prescribing antibiotics after discharge is controversial. This study aimed to investigate the effect of antibiotic administration in discharge prescription on surgical site infections.
Methods: Data from patients who underwent emergency laparoscopic cholecystectomy for acute calculous cholecystitis between January 2018 and February 2020 were retrospectively reviewed. Those with a decompensated systemic disease, those who were converted to open cholecystectomy, those with stage 3 disease, and those who underwent open cholecystectomy and cholecystostomy were excluded. Ampicillin-sulbactam 1 g was administered parenterally three times a day before and after surgery.
The patients were divided into two groups according to their discharge prescriptions: those who were given antibiotics (AB group) and those who were not given antibiotics (NA group). The primary outcome was the development of surgical site infections.
Results: 107 patients in the AB group and 109 in the NA group. Surgical site infection developed in 29 (13.4%) patients, 11 (10.3%) in the AB group, and 18 (16.5%) in the NA group. No significant difference was found between the two groups regarding surgical site infection rate (p>0.05). In logistic regression analysis, obesity was a risk factor for surgical site infections.
Conclusions: Failure to prescribe ampicillin-sulbactam to acute calculous cholecystitis patients discharged after laparoscopic surgery does not increase surgical site infections. However, prescribing ampicillin-sulbactam to obese patients may reduce surgical site infections.
Keywords: Surgical site infections, acute calculous cholecystitis, emergency laparoscopic cholecystectomy, obesity

References

  • Referans1. Fischer JE, ed. Mastery of surgery. 5 ed. Philadelphia: Lippincott Williams & Wilkins 2007.
  • Referans2. Duncan CB, Riall TS. Evidence-based current surgical practice: calculous gallbladder disease. J Gastrointest Surg 2012;16: 2011-25.
  • Referans3. Portincasa P, Moschetta A, Petruzzelli M, Palasciano G, Di Ciaula A, Pezzolla A. Gallstone disease: symptoms and Diagnosis of gallbladder stones. Best Pract Res Clin Gastroenterol. 2006;20: 1017–29.
  • Referans4. Attili AF, Carulli N, Roda E, Barbara B, Capocaccia L, Menotti A, Okoliksanyi L, Ricci G, Capocaccia R, Festi D, et al. Epidemiology of gallstone disease in Italy: prevalence data of the Multicenter Italian Study on Cholelithiasis (M.I.COL.). Am J Epidemiol. 1995;141: 158–65.
  • Referans5. Halldestam I, Enell EL, Kullman E, Borch K. Development of symptoms and complications in individuals with asymptomatic gallstones. Br J Surg 2004; 91: 734-738.
  • Referans6. Haisley KR, Hunter JG. Gallbladder and the Extrahepatic Biliary System. Brunicardi FC, Andersen DK, Billiar TR, editors. Schwartz’s Principles of Surgery. Eleventh Edition. New York: Mc Graw Hill;2019. pp. 1405-36.
  • Referans7. Hunter JG. Acute cholecystitis revisited: get it while it’s hot. Ann Surg. 1998;227(4):468-469.
  • Referans8. Ansaloni L, Pisano M, Coccolini F, et al. 2016 WSES guidelines on acute calculous cholecystitis. World J Emerg Surg. 2016; 11:25.
  • Referans9. Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35(6):605-627. doi:10.1086/676022
  • Referans10. Mangram AJ, Horan TC, Pearson ML, et al. (1999) Guideline for Prevention of Surgical Site Infection. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 27(2): 97-132.
  • Referans11. Regimbeau JM, Fuks D, Pautrat K, Mauvais F, Haccart V, Msika S, et al. Effect of postoperative antibiotic administration on postoperative infection following cholecystectomy for acute calculous cholecystitis: a randomized clinical trial. JAMA. 2014;312:145–54.
  • Referans12. Loozen CS, Kortram K, Kornmann VN, van Ramshorst B, Vlaminckx B, Knibbe CA, et al. Randomized clinical trial of extended versus single-dose perioperative antibiotic prophylaxis for acute calculous cholecystitis. Br J Surg. 2017;104: 151–7.
  • Referans13. Yokoe M, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Gomi H, et al. TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos). J Hepatobiliary Pancreat Sci 2013; 20: 35–46. DOI: 10.1007/s00534-012-0568-9.
  • Referans14. Gomi H, Solomkin JS, Schlossberg D, Okamoto K, Takada T, Strasberg SM, et al. Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci 2018; 25:3–16. DOI: 10.1002/jhbp.518. Epub 2018 Jan 9.
  • Referans15. Fuks D, Cosse C, Regimbeau JM. Antibiotic therapy in acute calculous cholecystitis. J Visc Surg 2013; Feb;150(1):3-8. doi: 10.1016/j.jviscsurg.2013.01.004.
  • Referans16. Strasberg SM. Clinical practice. Acute calculous cholecystitis. N Engl J Med 2008; 358: 2804.
  • Referans17. Solomkin JS, Mazuski JE, Bradley JS, et al. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Surg Infect (Larchmt). 2010 Feb;11(1):79-109. DOI: 10.1089/sur.2009.9930.
  • Referans18. Hirota M, Takada T, Kawarada Y, et al. Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines. J Hepatobiliary Pancreat Surg. 2007;14(1):78-82.
  • Referans19. Mazeh H, Mizrahi I, Dior U, et al. Role of antibiotic therapy in mild acute calculous cholecystitis: a prospective randomized controlled trial. World J Surg 2012; 36:1750-59.
  • Referans20. Gurusamy K, Samraj K, Gluud C, Wilson E, Davidson BR. Meta-analysis of randomized controlled trials on the safety and effectiveness of early versus delayed laparoscopic cholecystectomy for acute cholecystitis. Br J Surg. 2010;97(2):141-150.
  • Referans21. Jaafar G, Persson G, Svennblad B, Sandblom G. Outcomes of antibiotic prophylaxis in acute cholecystectomy in a population-based gallstone surgery registry. Br J Surg 2014;101:69-73. DOI: 10.1002/bjs.9369.
  • Referans22. Pierpont YN, Dinh TP, Salas RE, et al. Obesity and surgical wound healing: a current review. ISRN Obes. 2014; Feb 20;2014:638936. doi: 10.1155/2014/638936.
  • Referans23. Eming SA, Martin P, Tomic-Canic M. Wound repair and regeneration: mechanisms, signaling, and translation. Sci Transl Med. 2014; 6(265):265sr6.
  • Referans24. Alanis MC, Villers MS, Law TL, Steadman EM, Robinson CJ. Complications of cesarean delivery in the massively obese parturient. Am J Obstet Gynecol. 2010;203(3): 271.e1-271.e7.
There are 24 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Alpaslan Şahin 0000-0001-5707-1203

Kemal Arslan

Publication Date September 27, 2022
Published in Issue Year 2022 Volume: 13 Issue: 3

Cite

APA Şahin, A., & Arslan, K. (2022). Is Antibiotic Therapy Necessary after Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?. Turkish Journal of Clinics and Laboratory, 13(3), 360-365. https://doi.org/10.18663/tjcl.1131853
AMA Şahin A, Arslan K. Is Antibiotic Therapy Necessary after Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?. TJCL. September 2022;13(3):360-365. doi:10.18663/tjcl.1131853
Chicago Şahin, Alpaslan, and Kemal Arslan. “Is Antibiotic Therapy Necessary After Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?”. Turkish Journal of Clinics and Laboratory 13, no. 3 (September 2022): 360-65. https://doi.org/10.18663/tjcl.1131853.
EndNote Şahin A, Arslan K (September 1, 2022) Is Antibiotic Therapy Necessary after Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?. Turkish Journal of Clinics and Laboratory 13 3 360–365.
IEEE A. Şahin and K. Arslan, “Is Antibiotic Therapy Necessary after Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?”, TJCL, vol. 13, no. 3, pp. 360–365, 2022, doi: 10.18663/tjcl.1131853.
ISNAD Şahin, Alpaslan - Arslan, Kemal. “Is Antibiotic Therapy Necessary After Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?”. Turkish Journal of Clinics and Laboratory 13/3 (September 2022), 360-365. https://doi.org/10.18663/tjcl.1131853.
JAMA Şahin A, Arslan K. Is Antibiotic Therapy Necessary after Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?. TJCL. 2022;13:360–365.
MLA Şahin, Alpaslan and Kemal Arslan. “Is Antibiotic Therapy Necessary After Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?”. Turkish Journal of Clinics and Laboratory, vol. 13, no. 3, 2022, pp. 360-5, doi:10.18663/tjcl.1131853.
Vancouver Şahin A, Arslan K. Is Antibiotic Therapy Necessary after Emergency Laparoscopic Cholecystectomy for Acute Calculous Cholecystitis?. TJCL. 2022;13(3):360-5.


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