Port site infections after laparoscopic cholecystectomy

Abstract

Background: Port site infection (PSI) is an infrequent surgical site infection that complicates laparoscopic surgery but has a considerable influence in the overall outcome of laparoscopic cholecystectomy. The aim of this study was to evaluate factors that influence PSI after laparoscopic cholecystectomies and to analyze which of these factors can be modified to avoid PSI in a trail to achieve maximum laparoscopic advantages.Methods: Swabs were taken for culture and sensitivity in all patients who developed PSI. Exploration under general anesthesia, for patients, had deep surgical site infections and wound debridement been done, excisional biopsies had been taken for histopathological studies, and tissue samples for polymerase chain reaction for detection of Mycobacterium tuberculosis was done. All patients were followed up for six months postoperatively.Results: Port site infection rate was recorded in 40/889 procedures (4.5%), higher rates were observed in male patients 8/89 (8.9%), in acute cholecystitis 13/125 (10.4%), when spillage of bile, stones or pus occurred 24/80 (30%), and at epigastric port 32/40 (80%). Most of the PSI were superficial infections 77.5% with non-specific microorganism 34/40 (85%).Conclusions: There is a significant association of port site infection with spillage of bile, stones, or pus, with the port of gallbladder extraction and with acute cholecystitis. Especial consideration should be taken in chronic deep surgical site infection as Mycobacterium tuberculosis could be the cause. Most of the PSIs are superficial and more common in males.