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Revista chilena de cirugía

On-line version ISSN 0718-4026

Abstract

CLAROS, NATANIEL; MANTEROLA, CARLOS; VIAL, MANUEL  and  SANHUEZA, ANTONIO. Systematic review on the effectiveness of antimicrobial prophylaxis in elective laparoscopic cholecystectomy. Rev Chil Cir [online]. 2007, vol.59, n.5, pp.353-359. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262007000500008.

Background: Antimicrobial prophylaxis is a common practice in surgery. However its indication in elective laparoscopic cholecystectomy is controversial. Aim: To determine the effectiveness of antimicrobial prophylaxis in elective laparoscopic cholecystectomy. Material and methods: Systematic literature review of clinical trials and cohort studies in subjects over 18 years of age, comparing the effect antimicrobial prophylaxis versus placebo in the incidence of operative site infections. Cochrane, MEDLINE, Scielo and LiLACS databases were consulted. The methodological quality of studies was assessed using the MINCIR store, that ranges from 6 to 36. Results: Nine clinical trials and two cohort studies were analyzed. The mean MINCIR score of the studies was 18.5. The total population of all studies were 2271 patients (1196 receiving antimicrobial prophylaxis and 1077 receiving placebo). Both groups were comparable in age, weight, surgical time and length of hospital stay. The meta analysis gave a final odds ratio for the risk of infection of 0.73 (95% confidence interval 0.43-1.23). Sensitivity analysis, excluding cohort studies gave an odds ratio of 0.95 (95% confidence interval 0.48-1.9). Thus, in both situations no protective effect of antimicrobial prophylaxis on operative site infections was demonstrated. Conclusions: This systematic review does not support the use antimicrobial prophylaxis in elective laparoscopic cholecystectomy

Keywords : Cholecystectomy; antimicrobial prophylaxis; operative site infection.

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