Evidence map›Paper›PMID 30327917›Full record

SynthesisSurgical endoscopy2019

Antibiotic administration after cholecystectomy for acute mild-moderate cholecystitis: a PRISMA-compliant meta-analysis.

Davide La Regina, Matteo Di Giuseppe, Stefano Cafarotti, Andrea Saporito, Marcello Ceppi, Francesco Mongelli, Florian Bihl, Ruben Carlo Balzarotti Canger, Antonjacopo Ferrario di Tor Vajana

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 16 citations in OpenAlex.

  1. Review
  2. Article
  3. The Association of Polish Surgeons (APS) clinical guidelines for the use of laparoscopy in the management of abdominal emergencies. Part I.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2023
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Davide La Regina *Department of Surgery, San Giovanni Hospital, via Ospedale, Bellinzona, Switzerland.
Matteo Di Giuseppe *Department of Surgery, San Giovanni Hospital, via Ospedale, Bellinzona, Switzerland.
Stefano CafarottiDepartment of Surgery, San Giovanni Hospital, via Ospedale, Bellinzona, Switzerland.
Andrea SaporitoDepartment of Anaesthesiology, San Giovanni Hospital, Bellinzona, Switzerland.
Marcello CeppiUnit of Clinical Epidemiology, IRCCS - Ospedale Policlinico San Martino, Genova, Italy.
Francesco MongelliDepartment of Surgery, San Giovanni Hospital, via Ospedale, Bellinzona, Switzerland. francesco.mongelli@mail.com.ORCID http://orcid.org/0000-0002-8824-651X
Florian BihlDepartment of Hepatology, San Giovanni Hospital, Bellinzona, Switzerland.
Ruben Carlo Balzarotti CangerDepartment of Surgery, Ospedale Civico, Lugano, Switzerland.
Antonjacopo Ferrario di Tor VajanaDepartment of Surgery, San Giovanni Hospital, via Ospedale, Bellinzona, Switzerland.
Ospedale San Giovanni Bellinzona · CHOspedale Policlinico San Martino · ITOspedale regionale di Lugano · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAcute cholecystitis is a common disease and a frequent cause of emergency admission to surgical wards. Evidence regarding antibiotic administration in urgent procedures is limited and remains a contentious issue. According to the Tokyo guidelines, the antibiotic administration should be guided by the severity of cholecystitis, but internationally accepted guidelines are lacking. In particular, the need to perform antibiotic therapy after laparoscopic cholecystectomy is controversial for mild and moderate acute calculous cholecystitis (Tokio I and II). MATERIALS AND

methodsWe performed a comprehensive computer literature search of PubMed and MEDLINE databases in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. We selected patients treated with cholecystectomy for mild or moderate acute calculous cholecystitis (Tokio I or II), only randomized controlled trials, (post-operative antibiotic administration versus placebo or untreated), data about local or systemic infection rate in the next 30 days after surgery.

resultsThree hundred and fifty-nine articles were identified, and three articles were considered eligible for the meta-analysis, including 676 patients. Overall surgical site infections were documented in 18 (5.49%) of 328 patients treated with post-operative antibiotics versus 25 (7.18%) of 348 patients treated without post-operative antibiotics. Overall results and the subgroup analysis (superficial and deep incisional infection and organ/space infection) showed no statistically significant reduction of surgical site infections rate under antibiotic therapy.

conclusionsOur meta-analysis shows no significant benefit of extended antibiotic therapy in reducing SSI after cholecystectomy for mild and moderate acute cholecystitis (Tokio I and II). Further RCTs with adequate statistical power and involving a higher number of patients with subgroups are needed to better evaluate the benefit of post-operative antibiotic treatment in reducing the rate of organ/space surgical site infections.

Indexed as

CholecystectomyAnti-Bacterial AgentsCholecystitis, AcuteHumansPostoperative CareSeverity of Illness IndexSurgical Wound InfectionTreatment OutcomeAnti-Bacterial AgentsAntibioticsCalculousCholecystectomyCholecystitisGallstonesPost-operative

Identifiers

PMID30327917
OpenAlexW2897046654

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.