SIMULTANEOUS BACTERIOLOGICAL ASSESSMENT OF BILE FROM GALLBLADDER AND COMMON BILE-DUCT IN CONTROL SUBJECTS AND PATIENTS WITH GALLSTONES AND COMMON DUCT STONES

Objectives: To determine the simultaneous prevalence of bacteria in bi le from the gallbladder and common bile duct and to determine the infl uence of the number of stones present on bateriologic findings. Method s: A prospective study was performed in 467 subjects divided into seve n groups: 42 control subjects with normal biliary tracts, 221 patients with symptomatic gallstone disease, 12 patients with hydropic gallbla dder, 52 patients with acute cholecystitis, 67 patients with common bi le duct stones without cholangitis, 49 patients with common bile duct stones and acute cholangitis, and 24 patients with previous cholecyste ctomy and common bile duct stones. In all except controls, bile sample s from the gallbladder and common bile duct were taken simultaneously for aerobic and anaerobic cultures. Results: Control subjects had no b acteria in gallbladder bile. Patients with gallstones, acute cholecyst itis, and hydropic gallbladder had similar rates of positive cultures in the gallbladder and common bile duct, ranging from 22% to 46%, but the rate was significantly higher in patients with common bile duct st ones without cholangitis (58.2%). Patients with cholangitis or previou s cholecystectomy had a high rate of positive cultures of common duct bile (93% to 100%). Age greater than 60 years had a significant influe nce on the rate of positive bile cultures. There was no relationship b etween the number of stones in the gallbladder or common bile duct and the percentage of positive cultures. In 98% of the patients, the same bacteria were isolated from gallbladder and common duct bile. Conclus ions: In normal subjects, no bacteria were present in the biliary trac t. Among patients with common bile duct stones, there was an increasin g percentage of positive cultures according to the severity of the dis ease. Age had an important influence, but sex and the number of common bile duct stones had no influence on positive cultures.