Postoperative T-tube cholangiography: is routine antibiotic prophylaxis necessary? A prospective, controlled study
S. M. Sheen-Chen, Y. F. Cheng, F. F. Chou and T. Y. Lee
Department of Surgery, Chang Gung Memorial Hospital at Kaohsiung, Chang Gung Medical College, Taiwan, Republic of China.
OBJECTIVE: To determine the value of antibiotic prophylaxis for the
prevention of infection following postoperative T-tube cholangiography.
DESIGN: A prospective, controlled study. SETTING: A tertiary care center.
STUDY PARTICIPANTS: The role of antibiotic prophylaxis during postoperative
T-tube cholangiography was prospectively evaluated in 164 patients.
INTERVENTION: Sixty-two patients were administered antibiotic prophylaxis
treatment (1 g of cephalothin sodium was infused intravenously 30 minutes
before the procedure and 500 mg of cephalexin was given orally every 6
hours for 3 days after the procedure). Seventy-one patients were in the
control group and did not receive antibiotic therapy. MAIN OUTCOME
MEASURES: Complications and adverse reactions following postoperative
T-tube cholangiography were recorded and compared between the two groups.
RESULTS: There was no significant difference between the groups in regard
to age, sex, serum amylase level before T-tube cholangiography, white blood
cell count, and liver function. The results of the bacteriologic culture
specimens of the bile were also comparable between the groups. One patient
who had received antibiotic therapy and one patient in the control group
had fever (temperature, > 38 degrees C) and chills after the procedure.
Two patients who had received antibiotic therapy and one patient in the
control group had mild abdominal pain. These complications were treated
conservatively without any event. No significant difference was found in
the rates of complications and the success of postoperative T-tube
cholangiography between the groups. CONCLUSION: Routine antibiotic
prophylaxis for the prevention of infection following postoperative T-tube
cholangiography is not necessary under selected conditions.
