Bacteriology & high risk groups in cholecystectomy

Aerobic cultures of gallbladder wall and bile of 131 consecutive cholecystectomies yielded 42 percent positive cultures of the bile of the whole group and 70 percent of 30 gallbladder wall cultures. In 18.3 percent of the whole group (n = 13) minor wound infections were observed and 14.5 percent of non-infectious minor complications. There was no mortality in this group. The high risk group for wound infection in our group was found to be the old age group, acute cholecystitis group, choledocholithiasis and obstructive jaundice. In 66.6 percent of all patients with post-operative wound infections, the bacterial growth from bile and gallbladder wall and the operative wound was identical. The bacteria served as endogenous contaminators. Those bacteria were (in order of decreasing incidence): E. coli. Klebsiella aerogenes/aerobacter spp. and Streptococcus fecalis. The high risk group for infected bile should be treated with prophylactic antibiotics.