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A Prospective Clinical Study to Evaluate the Role of Prophylactic Antibiotics in Laparoscopic Cholecystectomy Patients: An Experience in Rural Setting

Mohit Gupta, Junior Resident, Department of Surgery, UP University of Medical Sciences, Saifai, Etawah, Uttar Pradesh 206130, India. , Somendra Pal Singh1 , Shashi Prakash Mishra2 , Mohit Gupta3

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New Indian Journal of Surgery 9(3):p 358-361, May-June 2018. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9318.21

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Abstract

Objectives: Three groups were compared on basis of postoperative symptoms and complications and overall duration of hospital stay to assess the role and rationale of use of antibiotics in patients undergoing Laparoscopic Cholecystectomy.

Setting: This study was done in a rural tertiary centre of western region of Uttar Pradesh state of India. This area caters a major population of Gall stone diseases.

Participants: 452 patients were included in the study between the age group of 18-60 yrs. Majority of patients in the study population were females (n=407; 90.04%). Female : Male ratio was 1:0.11.

Interventions: Patients were divided into 3 groups. In Grp A- No Antibiotics were given, in Grp B- preoperative single shot antibiotics were given at the time of induction, in Grp C- antibiotics were given both pre and post operatively.

Primary and secondary outcome measures: Surgical site infection, Pain as per VAS and postoperative symptoms were taken as primary outcome measures.

Results: At stitch removal most common complaint in overall patients was pain abdomen (n=63; 13.94%), followed by port-site infection (n=40; 8.85% each), fever (n=40, 8.85%) and vomiting (n=17; 3.76%). Prevalence of all the above complaints was higher in Group A compared to Group B and Group C, differences were found to be statistically significant only for vomiting, fever and port-site infection for Group A from group B and C while differences were not found to be significant between Group B and C.

Conclusions: After our study we recommend the use of single dose of preoperative antibiotics as they are sufficient and comparable to antibiotics given in both pre-operative and post-operative period in the low-risk elective Laparoscopic Cholecystectomy procedure. This will definitely demoralize the unjudicious use of antibiotics which have a risk of antibiotic resistance and other complications and will increase the cost effectiveness of the procedure.

Keywords: Laparoscopic Cholecystectomy; Antibiotics.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.9318.21

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