腹腔镜胆囊切除术前预防性应用抗生素的研究进展

Advances in Prophylactic Antibiotic Administration Prior to Laparoscopic Cholecystectomy

摘要: 腹腔镜下胆囊切除术(Laparoscopic cholecystectomy, LC)已成为治疗胆囊良性疾病的首选术式。随着胆囊良性疾病发病率逐年上升及LC手术量持续增长，术后感染病例也相应增多。因此，围手术期是否需预防性应用抗生素成为临床关注的焦点。尽管国内外已开展大量关于LC术前抗生素应用的研究，然而结论存在差异。现有指南及研究表明，低风险择期LC患者术前无需预防性使用抗生素，而对于轻中度急性胆囊炎患者是否需要预防性使用抗菌药物，仍缺乏统一结论。本文基于最新的国内外研究与指南，综述了当前LC围术期预防性抗生素应用的研究进展，为合理应用抗生素提供参考依据。

Abstract: Laparoscopic cholecystectomy (LC) has become the standard procedure for managing benign gallbladder diseases. With the rising incidence of these conditions, the number of LC surgeries has steadily increased, accompanied by a growing concern over postoperative infections. Whether prophylactic antibiotic administration is warranted during the perioperative period remains a subject of ongoing debate. Although extensive research—both domestically and internationally—has explored the role of preoperative antibiotic prophylaxis in LC, the findings have been inconsistent. Current Guidelines and clinical evidence indicate that prophylactic antibiotics are not recommended for low-risk elective LC. However, for mild-to-moderate acute cholecystitis, there is no consensus on the necessity of prophylactic antibiotic administration. This review synthesizes the guidelines and the latest evidence from recent studies worldwide to clarify current perspectives and to provide practical guidance for the judicious use of antibiotics in the perioperative management of LC.