BACTERIOLOGY OF CHOLELITHIASIS IN INFANTS AND CHILDREN

Today, laparoscopic cholecystectomy is rapidly replacing traditional c holecystectomy as the standard treatment of symptomatic cholelithiasis in children. We reviewed the bile cultures and postoperative course o f 30 children who underwent laparoscopic cholecystectomy with the aim of establishing a routine policy for perioperative antibiotic treatmen t and for the management of biliary leak during that procedure. A posi tive bile culture was found in only one child (Salmonella Group D). Al l patients, including six children with intraoperative bile spillage, had a completely normal and uneventful postoperative course. We conclu ded that the use of preoperative antibiotic treatment should be limite d in laparoscopic cholecystectomy in children and is probably not requ ired at all, awaiting proof from a further study. The present study fu rther showed that intraoperative bile spillage is of no clinical signi ficance and can be treated simply with local saline irrigation during the laparoscopic procedure.