August 1973

Preoperative Antibiotics in Biliary Surgery

Author Affiliations

From the Department of Surgery, University of Pittsburgh, the Western Pennsylvania Hospital (Dr. Chetlin), and the Veterans Administration Hospital (Dr. Elliott), Pittsburgh.

Arch Surg. 1973;107(2):319-323. doi:10.1001/archsurg.1973.01350200179037

Preoperative prophylactic cephaloridine was evaluated prospectively for its effect on bile cultures and postoperative septic complications in 84 patients undergoing biliary operations. These 84 patients were selected as "high risk" for postoperative sepsis because they were over 70 years of age or had acute cholecystitis, obstructive jaundice, or common duct stones without jaundice. Such patients have previously been shown to have positive bile cultures at operation in 58% to 72% of cases.

Cephaloridine in 1 gm doses, given twice before and twice following operation, failed to reduce the incidence of positive bile cultures. However, invasive infections occurred in only 4% of 47 treated patients, as compared to 27% of similar, but untreated, controls.