META-ANALISIS DAN SYSTEMATIC REVIEW: PENGARUH ANTIBIOTIK PROFILAKSIS PADA TERJADINYA SURGICAL SITE INFECTION PADA PASIEN KOLELITIASIS PASCA LAPAROSKOPI KOLESISTEKTOMI

Theresia Yulia Manibuy; Nataniel Tandirogang; Khemasili Kosala; Mona Zubaidah

Theresia Yulia Manibuy Program Studi Kedokteran
Nataniel 1. Program Studi Kedokteran, Fakultas Kedokteran Universitas Mulawarman 2. Laboratorium Ilmu Mikrobiologi, Fakultas Kedokteran Universitas Mulawarman
Khemasili 3. Laboratorium Ilmu Farmakologi, Fakultas Kedokteran Universitas Mulawarman
Mona 4. Laboratorium Ilmu Parasitologi, Fakultas Kedokteran Universitas Mulawarman

Keywords: Cholelithiasis, Prophylactic Antibiotics, Laparoscopic Cholecystectomy, Surgical Site Infection, Meta-Analysis

Abstract

Cholelithiasis is a gastrointestinal disease commonly found in doctors’ daily medical practice. It has occurred in 20 to 25 million people, representing 10-15% of adults in United States of America. The treatment of cholelithiasis consists of two methods, i.e., surgical method and non-surgical method. Laparoscopic cholecystectomy is a surgical method and the standard treatment in symptomatic cholelithiasis. Surgical site infection is an infection that may occur in patients undergoing surgery. One way to prevent surgical site infection after laparoscopic cholecystectomy is using antibiotics as prophylaxis. This meta-analysis aims to depict the statistical data on the influence of prophylactic antibiotics towards the occurrence of surgical site infection in patients with cholelithiasis after laparoscopic cholecystectomy. Journals that were analyzed were journals in English obtained through online database, e.g., Google Scholar, PubMed, and Springer within 2001- 2021 publication period. From the search result, 7,215 journals have been found that after getting critical review, 7 of them were selected. The method of analysis employed in this research was fixed effects model, and the data were analyzed using comprehensive meta-analysis software v3 trial. The result showed that the score of summary effect RR = 1.082 with significance test of p-value of 0.786 (p > 0.05 with 95% confidence interval). Thus, this research concludes that prophylactic antibiotics treatment has no significant influence towards the occurrence of surgical site infection in patients with cholelithiasis after laparoscopic cholecystectomy.

References

Agresta, F., Campanile, F. C., Vettoretto, N., Silecchia, G., Bergamini, C., Maida, P., Lombari, P., Narilli, P., Marchi, D., Carrara, A., Esposito, M. G., Fiume, S., Miranda, G., Barlera, S., Davoli, M., & On the behalf of The Italian Surgical Societies Working Group. (2015). Laparoscopic cholecystectomy: consensus conference-based guidelines. Langenbeck’s Archives of Surgery, 400(4), 429–453. https://doi.org/10.1007/s00423-015-1300-4
Bhar, A., & Karmakar, S. (2020). A Comparative Study of Open Cholecystectomy versus Laparoscopic Cholecystectomy- A Hospital Based Study. Journal of Evidence Based Medicine and Healthcare, 7(25), 1193–1197. https://doi.org/10.18410/jebmh/2020/255
Guler, Y., Karabulut, Z., Sengul, S., & Calis, H. (2019). The effect of antibiotic prophylaxis on wound infections after laparoscopic cholecystectomy: A randomised clinical trial. International Wound Journal, 16(5), 1164–1170.
Kumar, S., Lakhey, P. J., Vaidya, P., Patowary, B. N., Praveen, C. R., & Shrestha, P. (2011). Antibiotic prophylaxis in low risk patients undergoing laparoscopic cholecystectomy. Journal of College of Medical Sciences-Nepal, 7(1), 12–18.
Munckhof, W. (2005). Antibiotics for surgical prophylaxis. Australian Prescriber, 28(5), 115. https://doi.org/10.18773/austprescr.2005.090
Nurman, A. (2012). Batu Empedu. In Buku Ajar Ilmu Penyaki Hati (1st ed.). Sagung Seto.
Pateriya, A., Agrawal, M. P., & Samar, S. K. (2021). Open versus laparoscopic cholecystectomy: a comparative study on patient parameters. International Surgery Journal, 8(6), 1767. https://doi.org/10.18203/2349-2902.isj20212269
Retnawati, H., Apino, E., Kartianom, Djidu, H., & Anazifa, R. D. (2018). Pengantar Analisis Meta (Issue August 2019).
SAGES. (2010). guidelines for the clinical application of laparoscopic biliary tract surgery. Surgical Endoscopy, 24(10), 2368–2386. https://doi.org/10.1007/s00464-010-1268-7
Shaikh, S., Mallah, M. Q., Khatoon, S., & Laghari, Z. H. (2019). PROPHYLACTIC ANTIBIOTICS. ROLE STILL TO BE DEFINED IN ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY. The Professional Medical Journal, 26(02), 355–359.
Sharma, A., & Shah, A. (2018). Prophylactic Antibiotics in Elective Laparoscopic Cholecystectomy is it Necessary? Journal of Nepalgunj Medical College, 16(2), 16–18.
SIGN. (2008). Antibiotic Prophylaxis In Surgery. Scottish Intercollegiate Guideline Network.
Stinton, L. M., Myers, R. P., & Shaffer, E. A. (2010). Epidemiology of gallstones. Gastroenterology Clinics of North America, 39(2), 157–169. https://doi.org/10.1016/j.gtc.2010.02.003
Turk, E., Karagulle, E., Serefhanoglu, K., Turan, H., & Moray, G. (2013). Effect of cefazolin prophylaxis on postoperative infectious complications in elective laparoscopic cholecystectomy: a prospective randomized study. Iranian Red Crescent Medical Journal, 15(7), 581–586. https://doi.org/doi: 10.5812/ircmj.11111
Uludag, M., Yetkin, G., & Citgez, B. (2009). The role of prophylactic antibiotics in elective laparoscopic cholecystectomy. JSLS: Journal of the Society of Laparoendoscopic Surgeons, 13(3), 337.
Verma, R., Mittal, S. K., & Singla, N. K. (2020). A prospective study: role of prophylactic antibiotics versus no antibiotics in elective laparoscopic cholecystectomy. International Surgery Journal, 7(5), 1580–1586.
WHO. (2018). Global Guideliness For the Prevention of Surgical Site Infection.
Zhou, H., Zhang, J., Wang, Q., & Hu, Z. (2009). Meta‐analysis: antibiotic prophylaxis in elective laparoscopic cholecystectomy. Alimentary Pharmacology & Therapeutics, 29(10), 1086–1095.