INTRODUCTION: In this study, our aim was to evaluate effect of reusing sterilized disposable laparoscopic devices, on postoperative infection after laparoscopic cholecystectomy operation.
METHODS: 201 patients were included. Those were patients with symptomatic cholecystitis, who underwent elective laparoscopic cholecystectomy between years of 2007 and 2008. Cases of acute cholecystitis had been excluded. Patients were randomly chosen in to 3 separate groups. There were 139 patients in-group 1, 49 patients in group 2, and 13 patients in group 3. Group 1 patients were operated by using laparoscopic devices, which were sterilized by ethylene oxide. 2% gluteraldehyde solution was used for group 2 and group 2. Those groups were compared according to the patients’ demographic properties, operational findings, complications and postoperative follow up.
RESULTS: There was no statistical difference of age, sex, body-mass index, presence of diabetes mellitus, histroy of intra-abdominal operation, history of previous acute cholecystitis, intra-operational gallbladder perforation, usage of section drainage and hospitalization periods between these three groups. Group 1 was found to have significantly lower intra-operative time period than the other groups. Bile cultures of 23 patients from group 1, 6 patients from group 2 and 1 patient from group 3 were positive. But difference between groups was statistically significant. Postoperative infection was seen in one patient of group 1 and another single patient of group 2. This result also was statistically significant. Overall rate of postoperative infection was found to be 1% (2/201), when all three groups were included.
DISCUSSION AND CONCLUSION: Laparoscopic surgery is more expensive than open surgery. In many countries, including ours, disposable operation devices have been reused after sterilization. Worldwide postoperative infection rates following laparoscopic cholecystectomy are reported to exist between 0.4% and 1.1%. According to our results in this study, reuse of sterilized disposable laparoscopic devices can be considered to have no additional risk for postoperative infection.