Objective:To assess the effectiveness of antibiotic prophylaxis in lowrisk elective laparoscopic cholecystectomy (LC) by Metaanalysis.
Methods:Literatures of randomized controlled trials (RCTs) on prophylactic administration of antibiotics in elective LC patients with low risk of infection published from 1933 to October 2010 were retrieved. Eighteen studies were included for the analysis according to predefined inclusion and exclusion criteria, of which any study with a Jadad score below 3 was considered to be of poor quality and was excluded, thus 12 eligible studies were finally selected. The details about the trial design, characters of the subjects and results of the studies were reviewed and extracted by two independent evaluators. Data were analyzed via the Peto odds ratio (OR) method by using Revman 4.2 software.
Results: In elective LC paticnts with low risk of infection, no significant differences were noted between the antibiotic treatment group and nonantibiotic treatment group in respect of overall infection (OR=1.11, 95% CI:0.68~1.82, P=0.98), wound infection (OR=1.07, 95% CI:0.59~1.94, P=0.99), abdominal infection (OR=2.88, 95% CI:0.3~28.09, P=0.98), distant infection (OR=1.0, 95% CI:0.43~2.35, P=0.65) and bacterial culture of bile (OR=0.84, 95% CI:0.55~1.12, P=1.08). However, antibiotic treatment group showed a significantly less hospital stay than that of nonantibiotic treatment group (WMD=-0.16, 95% CI:-0.22~-0.09, P＜0.01).
Conclusions:The regimen of antibiotics for perioperative prophylaxis can not reduce the infection incidence of elective LC in patients with low risk of infection.