What is the role of antibiotic prophylaxis prior to laparoscopic cholecystectomy?

Updated: Apr 16, 2020
  • Author: Danny A Sherwinter, MD; Chief Editor: Kurt E Roberts, MD  more...
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Answer

Numerous studies have found no significant differences in the rate of surgical site infection (SSI) when perioperative antibiotics were compared with placebo in patients undergoing elective cholecystectomy. [55, 56, 57]

A systemic review by Sanabria et al assessed the use of antibiotic prophylaxis in laparoscopic cholecystectomy. [58] The review concluded that the available evidence was not sufficient either to support or to rule out the use of antibiotic prophylaxis to reduce SSIs. However, larger, randomized, clinical trials are needed.

Although it is the author’s practice to use antibiotics followed by surgery for patients with acute cholecystitis, this approach has not been studied in a randomized, controlled fashion. Published studies comparing different lengths of antibiotic courses in patients with acute cholecystitis who undergo cholecystectomy have shown no benefit to a longer course of antibiotics. [59]


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