A Prospective Study Comparing No Antibiotic versus Antibiotic Prophylaxis in Patients Undergoing Elective Laparoscopic Cholecystectomy

ABSTRACT

Laparoscopic cholecystectomy is one of the most common operations performed in general surgery. Elective laparoscopiccholecystectomy has a low risk for infective complications, and standard guidelines do not recommend prophylactic antibioticuse for low-risk cases. However, the use of antibiotic prophylaxis is very prevalent and the duration and dosage are inconsistentand varies widely among surgeons. This study is being done to assess the role of no antibiotic prophylaxis in the prevention ofwound infection in a patient undergoing elective laparoscopic cholecystectomy.Study Design and Period The study was conducted in the Department of General Surgery at Christian Medical College,Ludhiana. This was an open labeled study conducted from the period of January 1, 2014, to December 31, 2014.Results: 92 patients suffering from chronic calculous cholecystitis undergoing elective laparoscopic cholecystectomy wereincluded in the study. Group A with 23 cases without prophylactic antibiotic. Group B with 69 cases with two doses of prophylacticantibiotics Inj. cefuroxime 1.5 gram 30 min prior to induction and after 6 h. The majority of our 81patients (88.04%) were females.The male to female ratio was 18. 3 patients (3.27%) in Group B had associated comorbidities except for diabetes mellitus. Themajority of patients 14 (60.86%) in Group A had taken 1-2 h of operative time while 58 patients (84.05%) patients in Group Bwith statistical insignificant P = 0.05. There was no fever in Group A patients while in Group B 2 patients (2.89%) had fever onsecond post-operative day which was not related to surgical site infection and that was due to superficial thrombophlebitis. InGroup A 18 patients (78.26%) were discharged on second postoperative days while 46 patients (66.67%) patients in Group Bwere discharged on second postoperative day. 8 patients (11.59%) in Group B were discharged on third postoperative days.There was no statistical difference in the duration of hospitalization between the two groups with P = 0.22. The overall incidenceof postoperative infective complications were nil in both groups either with patients having no prophylactic antibiotic or thosehaving prophylactic antibiotics