Role of antibiotic prophylaxis in elective laparoscopic cholecystectomy: a prospective randomized observational study in tertiary care centre of India

Cholecystitis is inflammation of the gallbladder. Symptoms include right upper abdominal pain, nausea, vomiting, and occasionally fever. The pain lasts longer in cholecystitis than in a typical biliary colic. Without appropriate treatment, recurrent episodes of cholecystitis are common. During this study 229 patients were admitted with chronic cholecystitis of which 12 patients were excluded before randomization. The remaining 217 were randomized with 106 in the group A and 106 in group B. 5 patients were excluded because of open conversion in both the groups (2 in group A and 3 in group B). Preoperatively; No significant differences existed between the 2 groups regarding sex, age; body mass index and ASA score. Also, the duration of LC surgery, incidence of intraoperative gallbladder perforations and spillage of bile or stones, incidence of intra-operative bleeding from either cystic artery or gall bladder fossa and mean postoperative hospital stay were found not significantly different between the 2 groups. The parameters studied were age group, placement of drains, bile leak, hospital stay, Asepsis score, Surgical site infections, postoperative antibiotic used (after 24 hrs). In SSI in Group A, 95 (89.6%) had no SSI and 11 (superficial 8, deep 2, organ specific 1, total 10.4%) had SSI. In Group B, 96 (90.6%) had no SSI and 10 (superficial 7, deep 2, organ specific 1, total 9.4%) had SSI (p value 0.818). In both the groups the difference in the incidence of surgical site infections was not statistically significant.Hence prophylactic antibiotics do not reduce the risk of infective complications in patients undergoing laparoscopic cholecystectomy in low risk group of patients.