Laparoscopic Cholecystectomy for Simple Cholecystolithiasis in Risk Patients

2015 ◽  
pp. 180-184 ◽  
Author(s):  
T. M. Kocher ◽  
U. Herzog ◽  
P Kestenholz ◽  
J. -P Schuppisser ◽  
Ch. Ackermann ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Risk Patients

scholarly journals ANTIBIOTIC PROPHYLAXIS IN LAPAROSCOPIC CHOLECISTECTOMY: IS IT WORTH DOING?

2016 ◽  
Vol 29 (3) ◽  
pp. 170-172 ◽  
Author(s):  
Márcio Alexandre Terra PASSOS ◽  
Pedro Eder PORTARI-FILHO
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Antibiotic Prophylaxis ◽  
Infectious Complications ◽  
Low Risk ◽  
Double Blind Study ◽  
Significant Difference ◽  
Risk Patients ◽  
Group A ◽  
Elective Laparoscopic Cholecystectomy ◽  
Group B

ABSTRACT Background: Elective laparoscopic cholecystectomy has very low risk for infectious complications, ranging the infection rate from 0.4% to 1.1%. Many surgeons still use routine antibiotic prophylaxis Aim: Evaluate the real impact of antibiotic prophylaxis in elective laparoscopic cholecystectomies in low risk patients. Method: Prospective, randomized and double-blind study. Were evaluated 100 patients that underwent elective laparoscopic cholecystectomy divided in two groups: group A (n=50), patients that received prophylaxis using intravenous Cephazolin (2 g) during anesthetic induction and group B (n=50), patients that didn't receive any antibiotic prophylaxis. The outcome evaluated were infeccious complications at surgical site. The patients were reviewed seven and 30 days after surgery. Results: There was incidence of 2% in infection complications in group A and 2% in group B. There was no statistical significant difference of infectious complications (p=0,05) between the groups. The groups were homogeneous and comparable. Conclusion: The use of the antibiotic prophylaxis in laparoscopic cholecystectomy in low risk patients doesn't provide any significant benefit in the decrease of surgical wound infection.

scholarly journals 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Michele Pisano ◽  
Niccolò Allievi ◽  
Kurinchi Gurusamy ◽  
Giuseppe Borzellino ◽  
Stefania Cimbanassi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
High Risk ◽  
Emergency Surgery ◽  
Task Force ◽  
World Society ◽  
Online Questionnaire ◽  
High Risk Patients ◽  
Risk Patients ◽  
Key Questions

Abstract Background Acute calculus cholecystitis (ACC) has a high incidence in the general population. The presence of several areas of uncertainty, along with the availability of new evidence, prompted the current update of the 2016 WSES (World Society of Emergency Surgery) Guidelines on ACC. Materials and methods The WSES president appointed four members as a scientific secretariat, four members as an organization committee and four members as a scientific committee, choosing them from the expert affiliates of WSES. Relevant key questions were constructed, and the task force produced drafts of each section based on the best scientific evidence from PubMed and EMBASE Library; recommendations were developed in order to answer these key questions. The quality of evidence and strength of recommendations were reviewed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria (see https://www.gradeworkinggroup.org/). All the statements were presented, discussed and voted upon during the Consensus Conference at the 6th World Congress of the World Society of Emergency Surgery held in Nijmegen (NL) in May 2019. A revised version of the statements was voted upon via an online questionnaire until consensus was reached. Results The pivotal role of surgery is confirmed, including in high-risk patients. When compared with the WSES 2016 guidelines, the role of gallbladder drainage is reduced, despite the considerable technical improvements available. Early laparoscopic cholecystectomy (ELC) should be the standard of care whenever possible, even in subgroups of patients who are considered fragile, such as the elderly; those with cardiac disease, renal disease and cirrhosis; or those who are generally at high risk for surgery. Subtotal cholecystectomy is safe and represents a valuable option in cases of difficult gallbladder removal. Conclusions, knowledge gaps and research recommendations ELC has a central role in the management of patients with ACC. The value of surgical treatment for high-risk patients should lead to a distinction between high-risk patients and patients who are not suitable for surgery. Further evidence on the role of clinical judgement and the use of clinical scores as adjunctive tools to guide treatment of high-risk patients and patients who are not suitable for surgery is required. The development of local policies for safe laparoscopic cholecystectomy is recommended.

Sign in / Sign up

Export Citation Format

Share Document