Role of Antibiotic Prophylaxis in Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is one of the most common abdominal surgical procedures all over the world. It carries a lot of advantages over the open procedure. One of these advantages is the marked decrease in the incidence of surgical site infection. However, no wound is immune and SSI is still present and may be troublesome. The role of antibiotic prophylaxis in preventing or reducing SSI is still a matter of controversy in laparoscopic cholecystectomy. This study is a prospective one that conducted over two years to assess the role of antibiotic prophylaxis and best regimen. Four hundreds and fifty six patients were included which were divided into two large groups; group of simple cholecystectomy and group of risky cholecystectomy .Each group were further subdivided into three groups ; one received no antibiotic at all, the second received single dose of antibiotic, and a third one received antibiotic for at least five days. Sixteen cases developed SSI in the whole study (approximately 3.5%). Group of simple cholecystectomy reported three cases (~1%) suffered from SSI with insignificant value between the three groups. On the other hand in group B (risky group) , thirteen patients developed surgical site infections (~7%) with high statistical significance between the group where patient did not received antibiotics at all and other two groups received antibiotics. Also significant value was found between the group used single dose antibiotic (group 5) and those with at least five days administration of antibiotics, the latter reported less incidence of SSI. The study concluded that; no role of antibiotic prophylaxis in simple cholecystectomy. On the other hand prophylactic antibiotic is strongly recommended in risky cholecystectomy. It is better to give the antibiotic for at least five days in such risky groups. The presence of immune-comprised state,