TY - JOUR
T1 - Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy
T2 - is it really useful? A systematic review
AU - Ramírez-Giraldo, Camilo
AU - Van-Londoño, Isabella
AU - Pesce, Antonio
N1 - Publisher Copyright:
© 2025. The Author(s).
PY - 2025/1/10
Y1 - 2025/1/10
N2 - BACKGROUND: Empirical antibiotic therapy is often initiated during the hospital stay while awaiting laparoscopic cholecystectomy. This approach is generally justified in patients with moderate (Tokyo II) and severe (Tokyo III) acute cholecystitis, where organ dysfunction occurs as a result of the inflammatory or infectious process. However, there is no clear consensus regarding the use of antibiotics in patients with mild (Tokyo I) cholecystitis. This study aimed to evaluate the impact of preoperative antibiotic use on outcomes in patients with acute cholecystitis. METHODS: A systematic review of PubMed, Embase and Cochrane was conducted following the PRISMA methodology. Studies were eligible for inclusion if they were randomized controlled trials or non-randomized comparative studies evaluating the use or non-use of preoperative antibiotics in patients with acute cholecystitis. Eligible studies were required to provide at least one of the following datasets: postoperative complication rate, postoperative infectious complication rate, or positive culture rate. The synthesis reports were prepared using the Synthesis Without Meta-analysis (SWiM) framework. RESULTS: A total of 622 articles were initially identified, of which 2 met the inclusion criteria. These two articles included 331 patients. They reported higher rates of postoperative complications and bacterobilia in the group that received preoperative antibiotics; however, the differences were not statistically significant (p > 0.05). CONCLUSION: Based on current evidence, no recommendation can be made regarding the therapeutic use of antibiotics in mild acute cholecystitis while awaiting laparoscopic cholecystectomy.
AB - BACKGROUND: Empirical antibiotic therapy is often initiated during the hospital stay while awaiting laparoscopic cholecystectomy. This approach is generally justified in patients with moderate (Tokyo II) and severe (Tokyo III) acute cholecystitis, where organ dysfunction occurs as a result of the inflammatory or infectious process. However, there is no clear consensus regarding the use of antibiotics in patients with mild (Tokyo I) cholecystitis. This study aimed to evaluate the impact of preoperative antibiotic use on outcomes in patients with acute cholecystitis. METHODS: A systematic review of PubMed, Embase and Cochrane was conducted following the PRISMA methodology. Studies were eligible for inclusion if they were randomized controlled trials or non-randomized comparative studies evaluating the use or non-use of preoperative antibiotics in patients with acute cholecystitis. Eligible studies were required to provide at least one of the following datasets: postoperative complication rate, postoperative infectious complication rate, or positive culture rate. The synthesis reports were prepared using the Synthesis Without Meta-analysis (SWiM) framework. RESULTS: A total of 622 articles were initially identified, of which 2 met the inclusion criteria. These two articles included 331 patients. They reported higher rates of postoperative complications and bacterobilia in the group that received preoperative antibiotics; however, the differences were not statistically significant (p > 0.05). CONCLUSION: Based on current evidence, no recommendation can be made regarding the therapeutic use of antibiotics in mild acute cholecystitis while awaiting laparoscopic cholecystectomy.
KW - Acute cholecystitis
KW - Antibacterial agents
KW - Antibiotics
KW - Cholecystectomy
KW - Complications
UR - http://www.scopus.com/inward/record.url?scp=85215350921&partnerID=8YFLogxK
U2 - 10.1186/s13017-025-00574-x
DO - 10.1186/s13017-025-00574-x
M3 - Artículo
C2 - 39794804
AN - SCOPUS:85215350921
SN - 1749-7922
VL - 20
SP - 4
JO - World Journal of Emergency Surgery
JF - World Journal of Emergency Surgery
IS - 1
ER -