论文部分内容阅读
Background The role of routine antibiotic prophylaxis (ABP) in laparoscopic cholecystectomy(LC) in low-risk patients is remain controversial and do not supported by current guidelines.Nevertheless,routine ABP for LC is still usual in many clinical settings,in especial the developing countries.A meta-analysis was performed to evaluate the efficacy of ABP for LC in low-risk patients in the developing countries.Methods We searched multiple databases from establish to July 2013.Only randomized trials(RCTs) that compared perioperative ABP with control group (placebo or no antibiotics) in low-risk patients undergoing LC were searched.Then,24 studies qualified according to the inclusion criteria and Jadad scale by three authors independently.Only 10 RCTs of high-quality studies from developing countries were included for the meta-analysis.Random or fixed effects models were used by the I2.Funnel plot was used to assess publication bias according to the methods of Begg and Egger.Results 10 RCTs included 2516 patients.The meta-analysis of the 10 studies suggested that there is no statistically significant reduction was noted for ABP group and control group for overall infectious complications(OR=0.95,95%CI:0.58~1.55,I2=0%,P=0.84),superficial wound infectious complications(OR=0.87,95%CI:0.50~1.53,I2=0%,P=0.96),intra-abdominal infectious complications (OR=2.94,95%CI:0.30~28.49,I2=0%,P=0.99),distant infectious complications(OR=1.20,95%CI:0.45~3.20,I2=0%,P=0.64),positive bile bacteria cultures(OR=0.76,95%CI:0.53~1.09,I2=0%,P=0.97).However,prophylactic antibiotics prior to LC lead to shorter length of hospital stay (WMD= -0.16,95%CI:-0.28~-0.03,I2=72%,P=0.0007).The study sensitivity analyses were performed by differ effect size and the results also consistent to the meta-analysis.Conclusions Prophylactic antibiotic is not reducing the infectious complications,which suggested that it is unnecessary use ABP in low-risk patients undergoing laparoscopic cholecystectomy.