Microbiological Assessment of Bile During Cholecystectomy: Is All Bile Infected?

The Department of Surgery of the West Wales University, published in the September edtion of the Journal of the International Hepato Pancreato Biliary Association (HPB), a very interesting study. The aim was to determine the prevalence of bactibilia in patients undergoing cholecystectomy and to relate the presence or absence of organisms to the preoperative and postoperative course.

A total of 180 patients were collected, all being cholecystectomized during a 5 year period by a same surgeon. Risk factors for bactibilia (acute cholecystitis, common duct stones, emergency surgery, age > 70 years) were documented.

Seventy percent of the patients had complete data. Bacteria were identified in 15,6 % of cases. All patients had at least 1 risk factor. The overall incidence of infective complications was 20%. This study demonstrated that patients with uncomplicated choleclithiasis have aseptic bile. This sugests that use of prophylactic antibiotics should be limited to patients with risk factors for bactibilia.

HPB 2007; 9: 225-228

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