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抗生素在急性胆囊炎围术期应用的研究进展
Advances in the Perioperative Use of Antibiotics in Acute Cholecystitis

DOI: 10.12677/acm.2024.1482305, PP. 943-949

Keywords: 急性胆囊炎,抗生素,腹腔镜胆囊切除术
Acute Cholecystitis
, Antibiotics, Laparoscopic Cholecystectomy

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Abstract:

急性胆囊炎是普外科急腹症中的常见疾病,腹腔镜胆囊切除术(LC)是其主要治疗方法。然而,围术期感染仍然是术后并发症的重要风险因素。抗生素在急性胆囊炎围术期应用的研究旨在明确其预防策略、最佳使用时机及效果。研究表明,合理使用预防性抗生素能够降低手术部位感染(SSI)率,特别是在高风险患者中。然而,预防性抗生素的普遍应用存在争议,一些研究显示其并不能显著降低低风险患者的术后感染率。尽管如此,抗生素在围术期的选择和使用仍需基于患者具体情况和感染风险。本文综述了抗生素在急性胆囊炎围术期应用的现状与进展,为临床医生提供参考,以优化抗生素使用策略,减少术后感染和抗生素耐药性风险。
Acute cholecystitis is a common disease in general surgery acute abdomen, and laparoscopic cholecystectomy (LC) is its main treatment. However, perioperative infection remains an important risk factor for postoperative complications. The study on the perioperative use of antibiotics in acute cholecystitis aims to clarify its preventive strategies, optimal timing of use and effectiveness. Studies have shown that the judicious use of prophylactic antibiotics can reduce the rate of surgical site infection (SSI), especially in high-risk patients. However, the generalized use of prophylactic antibiotics is controversial, and some studies have shown that they do not significantly reduce postoperative infection rates in low-risk patients. Nonetheless, the selection and use of antibiotics in the perioperative period needs to be based on patient-specific circumstances and infection risk. This article reviews the current status and progress of antibiotic use in the perioperative period of acute cholecystitis to provide clinicians with a reference to optimize antibiotic use strategies and reduce the risk of postoperative infection and antibiotic resistance.

References

[1]  Kim, S.H., Yu, H.C., Yang, J.D., Ahn, S.W. and Hwang, H.P. (2018) Role of Prophylactic Antibiotics in Elective Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis. Annals of Hepato-Biliary-Pancreatic Surgery, 22, 231-247.
https://doi.org/10.14701/ahbps.2018.22.3.231
[2]  Gomes, C.A., Junior, C.S., Di Saveiro, S., Sartelli, M., Kelly, M.D., Gomes, C.C., et al. (2017) Acute Calculous Cholecystitis: Review of Current Best Practices. World Journal of Gastrointestinal Surgery, 9, 118-126.
https://doi.org/10.4240/wjgs.v9.i5.118
[3]  师颢华, 段绍斌. 抗生素在腹腔镜胆囊切除术围手术期的应用进展[J]. 新疆医学, 2016, 46(1): 102-105.
[4]  中华医学会外科学分会胆道外科学组. 急性胆道系统感染的诊断和治疗指南(2021版) [J]. 中华外科杂志, 2021, 59(6): 422-429.
[5]  Gomi, H., Solomkin, J.S., Schlossberg, D., Okamoto, K., Takada, T., Strasberg, S.M., et al. (2018) Tokyo Guidelines 2018: Antimicrobial Therapy for Acute Cholangitis and Cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 25, 3-16.
https://doi.org/10.1002/jhbp.518
[6]  Colling, K.P., Besshoff, K.E., Forrester, J.D., Kendrick, D., Mercier, P. and Huston, J.M. (2022) Surgical Infection Society Guidelines for Antibiotic Use in Patients Undergoing Cholecystectomy for Gallbladder Disease. Surgical Infections, 23, 339-350.
https://doi.org/10.1089/sur.2021.207
[7]  Gallaher, J.R. and Charles, A. (2022) Acute Cholecystitis. Journal of the American Medical Association, 327, 965-975.
https://doi.org/10.1001/jama.2022.2350
[8]  McGuckin, M., Shea, J.A. and Schwartz, J.S. (1999) Infection and Antimicrobial Use in Laparoscopic Cholecystectomy. Infection Control & Hospital Epidemiology, 20, 624-626.
https://doi.org/10.1086/501685
[9]  刘国礼. 我国腹腔镜外科的现状——156820例腹腔镜手术综合报告[J]. 中华普通外科杂志, 2001(9): 49-51.
[10]  Berríos-Torres, S.I., Umscheid, C.A., Bratzler, D.W., Leas, B., Stone, E.C., Kelz, R.R., et al. (2017) Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. Journal of the American Medical Association Surgery, 152, 784-791.
https://doi.org/10.1001/jamasurg.2017.0904
[11]  Young Kim, E. and Ho Hong, T. (2021) Empirical Antibiotics for Acute Cholecystitis—What Generation of Antibiotics Is an Appropriate Choice? A Prospective, Randomized Controlled Study. Journal of Hepato-Biliary-Pancreatic Sciences, 28, 848-855.
https://doi.org/10.1002/jhbp.926
[12]  Seidelman, J.L., Mantyh, C.R. and Anderson, D.J. (2023) Surgical Site Infection Prevention. Journal of the American Medical Association, 329, 244-252.
https://doi.org/10.1001/jama.2022.24075
[13]  Oliveira1, R.S.D., Silva, P.D., Queiroz, C.A.S., Terra-Júnior, J.A. and Crema, E. (2018) Prevalence of Bacteriobilia in Patients Undergoing Elective Colecystectomy. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 31, e1392.
https://doi.org/10.1590/0102-672020180001e1392
[14]  Hirata, B.H.N., Sasagawa, S., Navarini, A., Mateus, H.C., Pacheco Junior, A.M. and Salles, M.J.C. (2023) Comparison of Bacterial Profile of Gallbladder with Gallstones from Patients Undergoing Cholecystectomy Due to Complicated and Uncomplicated Cholelithiasis: Changes in the Epidemiological Scenario. Revista do Colégio Brasileiro de Cirurgiões, 50, e20233474.
https://doi.org/10.1590/0100-6991e-20233474-en
[15]  Park, S.E., Choi, H.J., You, Y.K. and Hong, T.H. (2022) Clinical Significance of Preoperative Antibiotic Use in Mild to Moderate Acute Inflammatory Gallbladder Disease: A Randomized Controlled Trial. Journal of Hepato-Biliary-Pancreatic Sciences, 30, 482-492.
https://doi.org/10.1002/jhbp.1237
[16]  中华医学会外科学分会胆道外科学组, 中国研究型医院学会加速康复外科专业委员会, 中华外科杂志编辑部, 等. 胆道外科抗菌药物规范化应用专家共识(2019版) [J]. 中华外科杂志, 2019, 57(7): 481-487.
[17]  Nitzan, O., Brodsky, Y., Edelstein, H., Hershko, D., Saliba, W., Keness, Y., et al. (2017) Microbiologic Data in Acute Cholecystitis: Ten Years’ Experience from Bile Cultures Obtained during Percutaneous Cholecystostomy. Surgical Infections, 18, 345-349.
https://doi.org/10.1089/sur.2016.232
[18]  Liang, B., Dai, M. and Zou, Z. (2016) Safety and Efficacy of Antibiotic Prophylaxis in Patients Undergoing Elective Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis. Journal of Gastroenterology and Hepatology, 31, 921-928.
https://doi.org/10.1111/jgh.13246
[19]  Sajid, M.S., Bovis, J., Rehman, S. and Singh, K.K. (2018) Prophylactic Antibiotics at the Time of Elective Cholecystectomy Are Effective in Reducing the Post-Operative Infective Complications: A Systematic Review and Meta-Analysis. Translational Gastroenterology and Hepatology, 3, 1-10.
https://doi.org/10.21037/tgh.2018.04.06
[20]  Jaafar, G., Sandblom, G., Lundell, L. and Hammarqvist, F. (2020) Antibiotic Prophylaxis in Acute Cholecystectomy Revisited: Results of a Double-Blind Randomised Controlled Trial. Langenbeck’s Archives of Surgery, 405, 1201-1207.
https://doi.org/10.1007/s00423-020-01977-x
[21]  Guler, Y., Karabulut, Z., Sengul, S. and Calis, H. (2019) The Effect of Antibiotic Prophylaxis on Wound Infections after Laparoscopic Cholecystectomy: A Randomised Clinical Trial. International Wound Journal, 16, 1164-1170.
https://doi.org/10.1111/iwj.13175
[22]  Kone, L.B., Torres, C., Banulescu, M., Maker, V.K. and Maker, A.V. (2020) Perioperative Broad-Spectrum Antibiotics Are Associated with Decreased Surgical Site Infections Compared to 1st-3rd Generation Cephalosporins after Open Pancreaticoduodenectomy in Patients with Jaundice or a Biliary Stent. Annals of Surgery, 275, 1175-1183.
https://doi.org/10.1097/sla.0000000000004216
[23]  于海. 择期腹腔镜胆囊切除术围手术期抗生素应用研究[J]. 中国现代药物应用, 2017, 11(4): 142-143.
[24]  La Regina, D., Di Giuseppe, M., Cafarotti, S., Saporito, A., Ceppi, M., Mongelli, F., et al. (2018) Antibiotic Administration after Cholecystectomy for Acute Mild-Moderate Cholecystitis: A Prisma-Compliant Meta-Analysis. Surgical Endoscopy, 33, 377-383.
https://doi.org/10.1007/s00464-018-6498-0
[25]  陈骁. 老年患者腹腔镜胆囊切除术围手术期抗生素应用[J]. 江苏医药, 2013, 39(2): 1.
[26]  徐光新, 崔伟伟. 老年患者腹腔镜胆囊切除术围手术期抗生素应用分析[J]. 中外医学研究, 2019, 17(21): 137-139.
[27]  Choudhary, A., Bechtold, M.L., Puli, S.R., Othman, M.O. and Roy, P.K. (2008) Role of Prophylactic Antibiotics in Laparoscopic Cholecystectomy: A Meta-Analysis. Journal of Gastrointestinal Surgery, 12, 1847-1853.
https://doi.org/10.1007/s11605-008-0681-x
[28]  Sanabria, A., Dominguez, L.C., Valdivieso, E. and Gomez, G. (2010) Antibiotic Prophylaxis for Patients Undergoing Elective Laparoscopic Cholecystectomy. Cochrane Database of Systematic Reviews, 2010, CD005265.
https://doi.org/10.1002/14651858.cd005265.pub2
[29]  贾昌林, 仁真尼布. 腹腔镜胆囊切除术围手术期预防性应用抗生素的必要性[J]. 西藏医药, 2022, 43(4): 51-52.
[30]  权其仁. 预防性应用抗生素对急性结石性胆囊炎腹腔镜胆囊切除术伤口感染的影响[J]. 药品评价, 2023, 20(12): 1549-1552.
[31]  Rather, J.M., Iqbal, J. and Manzoor, S. (2022) Role of Prophylactic Antibiotics in Elective Laparoscopic Cholecystectomy Surgical Site Infection.
[32]  胡明秋, 陈宝公, 宋希江. 择期腹腔镜胆囊切除术围手术期抗生素应用研究[J]. 中华普通外科杂志, 2004(10): 54-55.
[33]  Hajibandeh, S., Popova, P. and Rehman, S. (2019) Extended Postoperative Antibiotics versus No Postoperative Antibiotics in Patients Undergoing Emergency Cholecystectomy for Acute Calculous Cholecystitis: A Systematic Review and Meta-Analysis. Surgical Innovation, 26, 485-496.
https://doi.org/10.1177/1553350619835347
[34]  Lee, J.M., Kang, J.S., Choi, Y.J., Byun, Y., Jin, S.H., Yoon, K.C., et al. (2023) Suggested Use of Empirical Antibiotics in Acute Cholecystitis Based on Bile Microbiology and Antibiotic Susceptibility. The Official Journal of the International Hepato Pancreato Biliary Association, 25, 568-576.
https://doi.org/10.1016/j.hpb.2023.01.017

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