Does Using a Laparoscopic Approach to Cholecystectomy Decrease the Risk of Surgical Site Infection?

Chesley Richards, MD, MPH, Jonathan Edwards, MS, David Culver, PhD, T. Grace Emori, RN, MS, James Tolson, BS, Robert Gaynes, MD, National Nosocomial Infections Surveillance (NNIS) System, Centers for Disease Control and Prevention


Annals of Surgery. 2003;237(2) 

In This Article

Abstract and Introduction

Objective: To assess the impact of laparoscopy on surgical site infections (SSIs) following cholecystectomy in a large population of patients
Summary Background Data: Previous investigations have demonstrated that laparoscopic cholecystectomy is associated with a shorter postoperative stay and fewer overall complications. Less is known about the impact of laparoscopy on the risk for SSIs.
Methods: Epidemiologic analysis was performed on data collected during a 7-year period (1992-1999) by participating hospitals in the National Nosocomial Infections Surveillance (NNIS) System in the United States.
Results: For 54,504 inpatient cholecystectomy procedures reported, use of the laparoscopic technique increased from 59% in 1992 to 79% in 1999. The overall rate of SSI was significantly lower for laparoscopic cholecystectomy than for open cholecystectomy. Overall, infecting organisms were similar for both approaches. Even after controlling for other significant factors, the risk for SSI was lower in patients undergoing the laparoscopic technique than the open technique.
Conclusions: Laparoscopic cholecystectomy is associated with a lower risk for SSI than open cholecystectomy, even after adjusting for other risk factors. For interhospital comparisons, SSI rates following cholecystectomy should be stratified by the type of technique.

Laparoscopic cholecystectomy, introduced in the late 1980s, has replaced the open technique for the majority of the 770,000 cholecystectomy procedures performed in the United States each year.[1] Although laparoscopic cholecystectomy is less invasive, requires shorter hospitalizations, and is associated with faster recovery than open cholecystectomy, little is known about the impact of laparoscopy on the risk for surgical site infections (SSIs). To assess the impact of laparoscopy on SSIs, we analyzed data from the National Nosocomial Infections Surveillance (NNIS) system to describe the characteristics of SSIs for both techniques and to assess SSI risk following laparoscopic cholecystectomy compared to open cholecystectomy.