Prospective study of bacteremia following endoscopic retrograde cholangiopancreatography

ABSTRACT

This study was carried out on 30 patients submitted to E.R.C.P. [endoscopic retrograde cholangiopancreatography] in Kasr El-Aini G.I. Endoscopy Unit. All cases were subjected to full history taking, general and abdominal examination, bacteriological examination, laboratory investigations and ultrasonography prior to the procedure of E.R.C.P. Blood cultures were done before five and ten minutes after E.R.C.P. In an attempt to identify a potential source of infection, aspirates were taken from the common bile duct after injection of the contrast media. Swabs were taken from the endoscope and the cannula before and after E.R.C.P. In 4 control cases to evaluate the extent of sterility of the instrument used before E.R.C.P. and to detect any organisms contaminating them after the procedure. Positive blood cultures were detected in 6 patients representing an incidence of 20% and none of them exhibited chills or fever during the following 24 hours. Most of the bacteriemic cases showed pancreatic-biliary duct dilatation as seen by E.R.C.P. or ultrasonography. Five of the bacteriemic cases were diabetic and one case had a cirrhotic liver. E.R.C.P. is a helpful and safe procedure. The bacteriemia following it is usually asymptomatic. Prophylactic antibiotics are recommended in diabetics, cirrhotics and those discovered to have pancreatic-biliary duct obstruction