Clinical and bacteriological assessment in cholelithiasis

ABSTRACT

In a prospective study of 195 patients who underwent cholecystectomy, 184 [94.4%] cases had bile bacteriological studies. Positive cultures were found in 36 [19.6%] patients. E. Coli, Streptococcal strains, Klebsiella and Enterobactor were the commonest organisms isolated. The highest incidence of positive bile was in those patients who were over 60 years old [36.4%], those who had bilio-enteric fistulae [100%], acute cholecystitis [60%], and choledocholithiasis [50%]. Diabetic patients had a 28.6% incidence rate. Prophylactic antibiotics were given selectively to 39 [21.2%] high-risk patients. wound infection developed in 15 [8.2%] patients. Ten of these had positive bile, making up 27.8% of the total cases who had positive cultures. The other 5 cases had sterile bile, making up 3.4% of the total cases who had sterile bile. In the first group, wound and bile bacteria were the same in all cases except in one [90%] It was concluded that in patients with cholelithiasis, prophylactic antibiotics can be restricted to the high-risk group