BACTERIOLOGICAL INVESTIGATION OF BILE IN PATIENTS WITH CHOLELITHIASIS

The microflora in bile from the gallbladder and common bile duct was i nvestigated in 303 patients who underwent surgery for cholelithiasis. The purpose of this study was to identify current bacteria and bacteri al casts in the biliary tract and also to analyze the relationship bet ween bactericholia at the time of operation and postoperative infectio n. Bile cultures were positive in 38% of all patients, although a high er incidence of positive bile cultures occurred in patients over 70 ye ars of age (77%), those with common duct stones (83%), those with pigm ent stones (65%), and those who underwent gastrectomy (71%). The predo minant organisms were Escherichia coli (22%), Klebsiella (18%), and En terococcus (15%). Obligate anaerobes were less frequently seen (4%), b eing found only in patients with pigment stones and always mixed with aerobes. Four patients developed postoperative infections (1.3%) which were all caused by biliary bacteria. The following two factors may co ntribute to this low incidence of postoperative infections: our policy of operating electively whenever possible, and the prophylactic use o f antibiotics to which the organisms cultured from bile are sensitive.