Abstract

FACUNDO-NAVIA, Helena  and  TRUJILLO-VIDAL, Jorge Hernán. Gall bladder empyema and postoperative antibiotic treatment: Indication or tradition?. rev. colomb. cir. [online]. 2017, vol.32, n.1, pp.22-25. ISSN 2011-7582.  https://doi.org/10.30944/20117582.3.

Objective. To establish the relationship between the development of surgical site infection in patients with complicated acute cholecystitis and the length of postoperative antibiotic treatment at the surgical service of a tertiary level of care general hospital. Materal and methods. Retrospective transverse study in 91 patients, 44 men and 47 female, with 57 years average age that underwent emergency cholecystectomy at Hospital Santa Clara, Bogotá, Colombia, for complicated acute cholecystitis (gallbladder empyema, gangrenous cholecystitis, perforated cholecystitis or inflammatory mass). They received intravenous antibiotics for a mean of 4.5 days. Ampicillin-sulbactam was the most commonly used antibiotic. We studied the length of antibiotic treatment and the occurrence of surgical site infection after no less than 30 days of postoperative follow-up. Results. Six patients (6.6%) developed surgical site infection, four superficial and two of organ-space. All six had received antibiotic treatment for an average of 3.6 days. Conclusion. These findings do not suggest that postoperative antibiotic treatment can prevent the development of surgical site infection in patients with complicated acute cholecystitis and that the surgical findings of gallbladder empyema, gangrenous cholecystitis, perforated cholecystis or inflammatory mass aere per se indication to maintain the antibiotic treatment with the aim of preventing surgical site infection. It appears necessary to perform randomized prospective studies in order to gain firm conclusions.

Keywords : gallbladder; cholecystitis; acute; infection; Microbiology; antibiotic prophylaxis; therapeutics.

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