Wang M L
Second Affiliated Hospital, Jiangxi Medical College, Nanchang.
Zhonghua Wai Ke Za Zhi. 1990 May;28(5):278-80, 317-8.
In this study, the results of transhepatically aspirated bile culture, and cholangiography done in 220 cases with biliary tract diseases were presented. Aerobes and anaerobes were found in 76.4% and 64.7% of all samples respectively. Patients with partial common bile duct obstruction from stricture and choledocholithiasis had markedly higher positive cultures than that with simple gallbladder stones and complete common duct obstruction secondary to carcinomas of the pancreas or ampulla. Bile culture from patients with symptomatic cholangitis was much more often positive than those with asymptomatic cholangitis. It was also found that patients with positive bile cultures were more prone to after-PTC acute cholangitis. This study suggested that bile organisms are mainly from the gut, bile organisms and bile duct obstruction are two major causes of acute cholangitis, abrupt elevation of bile pressure during PTC procedure was also a causing factor of acute cholangitis. The authors advocate the comprehensive and prophylactic use of antibiotics both effective to aerobes and anaerobes in the treatment of biliary tract infection.