복강경하 담낭 절제술 시행 시 예방적 항생제 사용에 대한 전향적 분석

A Prospective Study of Prophylatic Antibiotics for Laparoscopic Cholecystectomy

Purpose: We wanted to clinically evaluate the antibiotic therapy used from pre- to post- laparoscopic cholecystectomy along with the improved surgical techniques and instruments and the patient nutrition. Methods: We prospective studied 105 patients who were treated with laparoscopic cholecystectomy for acute and chronic cholecystitis at Busan St. Mary Hospital from March 2007 to January 2008. The two groups were divided as follows: (A) the group was not injected with antibiotics, and the other group (B) was injected with antibiotics. We did not used antibiotics when the patient had no acute aggravating symptoms, and we exclude the patients with old age (>70 years), a past history of diabetes mellitus (DM) or hypertension (HTN), and a past operation history. Results: Between the two group, there was no difference when they were compared for age, BMI (Body Mass Index), the operation time (minute) and the length of the hospital stay: (A) Group 49.3${\pm}$13.0 years, 24.4${\pm}$3.2 kg/$m^2$, 37.9${\pm}$10.0 minute and 4.6${\pm}$1.3 days, respectively, and (B) Group 55.9${\pm}$15.6 years, 23.5${\pm}$3.5 kg/$m^2$, 43.2 ${\pm}$ 23.8 minute and 5.5 ${\pm}$ 2.5 days, respectively. There was a significant different in the leukocyte count and the % of neutrophils: (A) Group 6396$\mu\ell^{-1}$ and 53.4%, respectively and (B) Group 9354$\mu\ell^{-1}$ and 66.6%, respectively. In (B) group, there were 2 cases of atrial fibrillation, 1 case of diarrhea and 1 case of wound seroma. There were no surgical related complications in group (A). Conclusion: For the well nourished chronic cholecystitis patients, the use of the prophylatic antibiotics may be less effective because of the many drug-induced side effects. More studies about the use of prophylactic antibiotics are needed.