ABSTRACT
To provide scientific basis for selecting a prophylactic antibiotic in the cases of elective cholecystectomy, according to our local conditions. Descriptive Study. General Surgery department of Abbasi Shaheed Hospital Karachi from 1st Jan, 2004 to 31st Dec 2004. Fifty patients with chronic cholecystitis ranged between 20 to 65 years were admitted through outpatient department. These patients also included high risk patients with diabetes mellitus, ischaemic heart diseases, hypertension and immunocompromised patients. Patients with acute cholecystitis, empyema, obstructive jaundice, common bile duct stone, carcinoma of gallbladder or biliary tree, cirrhosis and patients having septic foci elsewhere were excluded. Patients were selected according to convenient sampling. During cholecystectomy bile was sent for culture and sensitivity. For analysis of data SPSS-10 was used. In this study positive bile culture was found in 44 percent of cases and most prevelant organisms were E.coli and Klebsiella. With regard to antibiotic sensitivity. Amikacin, quinolone, imipiname and piperacillin has shown almost 90% sensitivity. Prophylactive antibiotic should be used in all cases of elective cholecystectomy
Subject(s)
Humans , Male , Female , Cholecystectomy , Microbial Sensitivity Tests , Antibiotic Prophylaxis , Gallstones , Cholecystitis/drug therapy , Cholecystitis/microbiologyABSTRACT
We are reporting a case of a 43-year-old Chinese male from Hong Kong, who came to see a doctor complaining of acute onset of severe upper abdominal pain. A diagnosis of acute cholecystitis was made and an emergency cholecystectomy was carried out. On opening the common bile duct, lancet-shaped worms were seen emerging from it. About 45 adult worms were collected and sent to the Department of Parasitology University of Malaya for identification. The worms were identified as Clonorchis sinensis. After the operation the patient was treated with praziquantel and he had an uneventful recovery.
Subject(s)
Adult , Animals , Bile Ducts/parasitology , Cholecystectomy , Cholecystitis/drug therapy , Clonorchiasis/complications , Clonorchis sinensis , Hong Kong , Humans , Male , Praziquantel/therapeutic useABSTRACT
The bile was collected from fro patients with biliary infections, with the bacterium isolated to study the sensitivity of each kind of the bacterium to several antibiotics in common use. Except G- bacterium, we also found some kinds of G+ bacterium in infection bile. G- bacterium were not sensitive to Clindamycin, G+ bacterium were sensitive to Ciprofloxacin. Escherichia coli, Xanthomonas maltophilia, Enterobacter cloacae, Pseudomonas aeruginosa were sensitive to Ampicillin. G+ bacterium were not sensitive to Azactam. Enterococcus faecalis, Enterococcus faecium, Enterobacter cloacae were not sensitive to Ceftazidime. Enterococcus faecalis, Staphylococcus coagulase negative, Staphylococcus epidermidis, Pseudomonas aeruginosa were not sensitive to Ceftriaxone Sodium. We didn't found any bacterium resistance Imipenem. The possibility of the existence of G+ bacterium as well as drug resistance should be considered n patients with biliary infections. The value of susceptibility test should be respected to avoid drug abuse of antibiotics.
Subject(s)
Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Cholecystitis/drug therapy , Cholecystitis/microbiology , Drug Resistance, Bacterial , Enterobacter aerogenes/drug effects , Enterococcus faecalis/drug effects , Escherichia coli Infections/drug therapy , Gram-Positive Bacterial Infections/drug therapy , Klebsiella Infections/drug therapy , Klebsiella pneumoniae/drug effects , Microbial Sensitivity TestsABSTRACT
Se estudió microbiologicamente el líquido vesicular (LV) de 132 pacientes litiásicos sometidos a colecistectomía. Hubo predominio del sexo femenino (66 por ciento). La presencia de infección fue predominante en aquellos pacientes de mayor edad. Se recuperaron microorganismos en 34 pacientes (20 por ciento); en su gran mayoría fueron aislamientos monomicrobianos (71 por ciento). En la mayoría de los casos el examen directo (Gram) predijo los cultivos positivos. Esto es muy importante, ya que su correlación con los cultivos es alta, por lo que constituye un elemento de guía para la elección racional de la terapia con antibióticos (ATB), sugiere el tipo de ATB, selecciona a los pacientes susceptibles al mismo, ya sea para su prolongación o la transformación de la profilaxis en tratamiento
Subject(s)
Humans , Ampicillin/therapeutic use , Bile/drug effects , Bile/microbiology , Cephalosporins/therapeutic use , Cholecystectomy/standards , Cholecystectomy/statistics & numerical data , Cholecystitis/diagnosis , Cholecystitis/drug therapy , Cholecystitis/microbiology , Escherichia coli/drug effects , Antibiotic Prophylaxis/statistics & numerical data , Antibiotic Prophylaxis , Sulbactam/therapeutic use , Argentina , Bibliographies as TopicABSTRACT
Las prostaglandinas GE2 inducen en la vesícula aumento de secreción de líquido intravesicular, aumento de la tensión, favorece la fuerza de contracción y disminuyen la capacidad de absorción. En el presente trabajo los pacientes tratados con 100 mg de indometacina vía rectal BID, demuestraron una disminución de los diámetros y área significativa P < 0.05 a las 24 y 48 horas. El volumen vesicular a las 24 horas era de ESP 9,10 cm3, 95% IC - 55,28 + 73,49 P < 0,05; a las 48 horas era de ESP 8,57 cm3, 95% IC - 55,16 + 68,30 P < 0,05. La reducción del score del dolor a las 24 y 48 horas es significativo P < 0,001. En el grupo que recibió Baralcina 1 amp IV C/12 horas, también demostramos disminución de los diámetros y área vesicular a las 24 y 48 horas P > 0,10 NS. El volumen vesicular se redujo a las 24 horas: ESP 5,94 cm3, 95% IC - 64,72 + 76,60 P > 0,10 NS; a las 48 horas: ESP 3,5 cm3, 95% IC - 59,52 + 66,52 P > 0,40 NS. La reducción del puntaje del dolor es significante P < 0,001 sólo a las 48 horas. En el grupo tratado con indometacina el número de pacientes sin dolor a las 48 horas es significativamente mayor, ESP 0,21; 95% IC - 0,46 + 0,88 P < 0,001. En conclusión la indometacina es un medicamento útil en el tratamiento del cólico biliar y colecistitis, debido a que reduce el volumen vesicular, la tensión, el dolor y la fuerza de contracción
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cholecystitis/drug therapy , Colic/drug therapy , Gallbladder Diseases/drug therapy , Indomethacin/therapeutic use , Acute Disease , Benzophenones/therapeutic use , Dipyrone/therapeutic use , Drug Combinations , Piperidines/therapeutic use , SuppositoriesABSTRACT
Se han estudiado 42 pacientes operados con diagnóstico de Colecistitis a los que se les realizó cultivo vesicular, encontrándosele 68% de cultivos positivos, fundamentalmente a E. Coli, Klebsiella y Salmonella tiphy. El 42.8% de los pacientes con cultivo vesicular positivo desarrollo complicación infecciosa a diferencia de 7.1% de pacientes que tuvieron cultivo negativo. El tiempo de hospitalización fue más prolongado (12 días) en los mencionados pacientes mientras que este se redujo a 7 días en los segundos. Se demuestra la importancia clínica del cultivo vesicular, haciéndose imperativo recomendar la toma de cultivo vesicular en los pacientes que se operan de las vías biliares, para adecuar la terapia antibiótica y reducir la morbilidad