Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review
Abstract 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 o...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | World Journal of Emergency Surgery |
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| Online Access: | https://doi.org/10.1186/s13017-025-00574-x |
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| author | Camilo Ramírez-Giraldo Isabella Van-Londoño Antonio Pesce |
| author_facet | Camilo Ramírez-Giraldo Isabella Van-Londoño Antonio Pesce |
| author_sort | Camilo Ramírez-Giraldo |
| collection | DOAJ |
| description | Abstract 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. |
| format | Article |
| id | doaj-art-3d9e785bcde740dbbfafb6d23defe0b7 |
| institution | Kabale University |
| issn | 1749-7922 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj-art-3d9e785bcde740dbbfafb6d23defe0b72025-01-12T12:12:34ZengBMCWorld Journal of Emergency Surgery1749-79222025-01-012011710.1186/s13017-025-00574-xPre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic reviewCamilo Ramírez-Giraldo0Isabella Van-Londoño1Antonio Pesce2Department of Surgery, Hospital Universitario Mayor – MéderiUniversidad del RosarioDepartment of Surgery, Azienda Unità Sanitaria Locale Ferrara, University of FerraraAbstract 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.https://doi.org/10.1186/s13017-025-00574-xAcute cholecystitisAntibacterial agentsAntibioticsCholecystectomyComplications |
| spellingShingle | Camilo Ramírez-Giraldo Isabella Van-Londoño Antonio Pesce Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review World Journal of Emergency Surgery Acute cholecystitis Antibacterial agents Antibiotics Cholecystectomy Complications |
| title | Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review |
| title_full | Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review |
| title_fullStr | Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review |
| title_full_unstemmed | Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review |
| title_short | Pre-operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy: is it really useful? A systematic review |
| title_sort | pre operative antibiotics in patients with acute mild cholecystitis undergoing laparoscopic cholecystectomy is it really useful a systematic review |
| topic | Acute cholecystitis Antibacterial agents Antibiotics Cholecystectomy Complications |
| url | https://doi.org/10.1186/s13017-025-00574-x |
| work_keys_str_mv | AT camiloramirezgiraldo preoperativeantibioticsinpatientswithacutemildcholecystitisundergoinglaparoscopiccholecystectomyisitreallyusefulasystematicreview AT isabellavanlondono preoperativeantibioticsinpatientswithacutemildcholecystitisundergoinglaparoscopiccholecystectomyisitreallyusefulasystematicreview AT antoniopesce preoperativeantibioticsinpatientswithacutemildcholecystitisundergoinglaparoscopiccholecystectomyisitreallyusefulasystematicreview |