2010, Number 3
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Cir Cir 2010; 78 (3)
Bactibilia e infección del sitio quirúrgico posterior a colecistectomía abierta
Velázquez-Mendoza JD, Álvarez-Mora M, Velázquez-Morales CA, Anaya-Prado R
Language: Spanish
References: 23
Page: 239-243
PDF size: 259.57 Kb.
ABSTRACT
Background: Bactibilia is the presence of bacteria in gallbladder bile and may play a role in the appearance of septic complications. It has been related to increased rates of surgical site infection after cholecystectomy. In this study we investigated whether bactibilia correlates with the presence of surgical site infection after cholecystectomy.
Methods: In this observational and descriptive study we investigated those patients operated by open cholecystectomy because of chronic cholecystitis. Patients had bile culture during surgery (January-December 2006). There were two study groups: patients with negative biliary culture (group 1) and patients with positive biliary culture (group 2). Variables were age, gender, biliary culture reports, abscess, cellulitis, seroma, and hematoma. Statistical analysis included Pearson χ
2 or Fisher’s exact test. For independent variables, Student t-test was used.
Results: Eighty patients were included (n = 40 per group). There we re 24 males (30%) and 56 females (70%) who had open cholecystectomy and had biliary culture. General morbidity was 42.50% and surgical site infection rate in general was 11.25%. There were two patients with abscesses and two patients with cellulitis in group 1. There were four patientswith abscesses and one patient with cellulitis in group 2. There was no statistically significant difference when comparing surgical site infection in both groups.
Conclusions: The presence of bacteria in gallbladder cultures does not correlate with the development of surgical site infection after open cholecystectomy.
REFERENCES
Laycock WS, Siewers AE, Birkmeyer CM, Wennberg DE, Birkmeyer JD. Variation in the use of laparoscopic cholecystectomy for elderly patients with acute cholecystitis. Arch Surg 2000;135:457-462.
Kim J, Ihm C. Usefulness of bile cultures and predictive factors for bacteriobilia in percutaneous cholecystostomy in patients with acute cholecystitis. Korean J Lab Med 2007;27:281-285.
Bizueto RH, Hernández PN, Jaime GG. Morbilidad y mortalidad en la cirugía de urgencia de la colecistitis crónica litiásica agudizada. Cir Ciruj 2002;70: 82-85.
Chandrashekhar C, Seenu V, Misra MC, Rattan A, Kapur BM, Singh R. Risk factors for wound infection following elective cholecystectomy. Trop Gastroenterol 1996;17:230-232.
Hancke E, Nusche A, Marklein G. Bacteria in the gallbladder wall and gallstones: indications for cholecystectomy. Langenbecks Arch Chir 1986;368:249-254.
Stewart L, Griffiss JM, Gary A, Jarvis GA, Way LW. Gallstones containing bacteria are biofilms: bacterial slime production and ability to form pigment solids determines infection severity and bacteremia. J Gastrointest Surg 2007;11:977-984.
Galili O, Eldar S, Matter I, Madi H, Brodsky A, Galis I, et al. The effect of bactibilia on the course and outcome of laparoscopic cholecystectomy.Eur J Clin Microbiol Infect Dis 2008;27:797-803.
Thompson JE, Bennion RS, Doty JE, Muller EL, Pitt HA. Predictive factors for bactibilia in acute cholecystitis. Arch Surg 1990;125:261-264.
Truedson H, Elmros T, Holm S. The incidence of bacteria in gallbladder bile at acute and elective cholecystectomy. Acta Chir Scand 1983;149:307-313.
Lillemoe KD. Surgical treatment of biliary tract infections. Am Surg 2000;66:138-144.
Hambraeus A, Laurell G, Nybacka O, Whyte W. Biliary tract surgery: a bacteriologic and epidemiologic study. Acta Chir Scand1990;156:155-162.
Higgins A, London J, Charland S, Ratzer E, Clark J, Haun W, et al. Prophylactic antibiotics for elective laparoscopic cholecystectomy: are they necessary? Arch Surg 1999;134:611-613.
Hernández-Sánchez J, Díaz-Araujo F, Osorio-Morales S. Identificación de flora bacteriana en cultivos de bilis de pacientes sometidos a cirugía biliar. Kasmera 2002;30:63-73.
Roa I, Ibacache G, Carvallo J, Melo A, Araya J, De Aretxabala X, et al. Microbiological study of gallbladder bile in a high risk zone for 0gallbladder cancer. Rev Med Chil 1999;127:1049-1055.
Melzer M, Toner R, Lacey S, Bettany E, Rait G. Biliary tract infection 0and bacteraemia: presentation, structural abnormalities, causative organisms and clinical outcomes. Postgrad Med J 2007;83:773-776.
Al-Abassi AA, Farghaly MM, Ahmed HL, Mobasher LL, Al-Manee MS. Infection after laparoscopic cholecystectomy: effect of infected bile and infected gallbladder wall. Eur J Surg 2001;167:268-273.
Grande M, Torquati A, Farinon AM. Wound infection after cholecystectomy. Correlation between bacteria in bile and wound infection after operation on the gallbladder for acute and chronic gallstone disease. Eur J Surg 1992;158:109-112.
Calpena R, Sánchez L, Candela P, Pérez V, Vázquez R, Diego E, et al. Hallazgos bacteriológicos como factor pronóstico en la evolución de la colecistitis aguda. Rev Esp Enferm Apar Dig 1989;76:465-470.
Beardsley SL, Shlansky-Goldberg RD, Patel A, Freiman DB, Soulen MC, Stavropoulos SW, et al. Predicting infected bile among patients undergoing percutaneous cholecystostomy. Cardiovasc Intervent Radiol 2005;28:319-325.
Badia JM, Williamson RCN. Antibióticos e infección biliar. Cir Esp 2004;76:203-206.
Dervisoglou A, Tsiodras S, Kanellakopoulou K, Pinis S, Galanakis N, Pierakakis S, et al. The value of chemoprophylaxis against enterococcus species in elective cholecystectomy. A randomized study of cefuroxime vs. ampicillin-sulbactam. Arch Surg 2006;141:1162- 1167.
Choudhary A, Bechtold CA, Puli SR, Othman MO, Roy PK. Role of prophylactic antibiotics in laparoscopic cholecystectomy: a metaanalysis. J Gastrointest Surg 2008;12:1847-1853.
Kanafani ZA, Khalifé N, Kanj SS, Araj GF, Khalifeh M, Sharara AI. Antibiotic use in acute cholecystitis: practice patterns in the absence of evidence based guidelines. J Infect 2005;51:128-134.