Abstract
This study presents a clinical case analyzing risk factors for the development of antibiotic resistance in abdominal surgery, with particular emphasis on the effectiveness of preventive and therapeutic strategies despite a complex risk profile. The patient underwent laparoscopic cholecystectomy complicated by bile contamination and subsequent conversion to open surgery. The postoperative course was further challenged by multiple preoperative comorbidities, including obesity and type 2 diabetes mellitus, as well as prior antibiotic exposure, all contributing to a high risk of multidrug-resistant infection. The uniqueness of this case lies not only in the combination of significant risk factors, but in the favorable clinical outcome achieved through timely diagnosis, targeted antimicrobial therapy, strict antibiotic stewardship, and optimized perioperative management. This case highlights the importance of comprehensive risk assessment, individualized treatment strategies, and reinforced infection control measures in mitigating antibiotic resistance in abdominal surgery.