What Should be Done for Perforation of the Gallbladder During Laparoscopic Cholecystectomy: Prophylaxis or Treatment?

Background: Iatrogenic perforation of the gallbladder during laparoscopic cholecystectomy (LC) is one of the most common intraoperative complications, and there is no clear consensus among surgeons on this issue and there are studies reporting the antibiotic treatment. The aim of this study is to determine the effect of type and duration of antibiotic use on infective complications between iatrogenic perforations of the gallbladder during LC patients. Methods: Patients who developed iatrogenic perforation of gallbladder during LC were subdivided into three groups according to antibiotic treatment; single dose intravenous (i.v.) antibiotic group, prophylactic antibiotic + additional dose i.v. antibiotic group, and prophylaxis + additional dose i.v. antibiotic + oral antibiotic group. Results: A total of 577 patients who underwent LC were included in the study, and 114 patients (19.8%) had iatrogenic perforation of gallbladder. No statistically significant difference was found in wound infection and surgical site infection in all three groups (P > .05). Conclusions: We suggest that single dose antibiotic use is sufficient to prevent infectious complications in patients who had iatrogenic perforation of the gallbladder during LC. Adding intravenous and/or oral antibiotics does not contribute to prevention of infective complications in these patients.