The Absent Role of Prophylactic Antibiotics in Low-Risk Patients Undergoing Laparoscopic Cholecystectomy

A retrospective chart review was done to determine the infection rate and the use of prophylactic antibiotics in consecutive laparoscopic cholecystectomies done in a single community. Incisional infections were discovered in 11 of 566 cases, 10 of whom had received prophylactic antibiotics. The infected patients were significantly older, had longer procedures, and had more comorbidity than the uninfected patients. They were also more likely to have a palpable mass preoperatively and past biliary surgery. A second, prospective study was done to evaluate the efficacy of the use of antibiotic prophylaxis in low-risk patients. Fifty-three patients were randomized into two double-blinded groups. No incisional infections occurred in either group within 30 days postoperatively. This suggests prophylactic antibiotics are not needed to prevent infections for low-risk patients undergoing laparoscopic cholecystectomy.