Cox J L, Helfrich L R, Pass H I, Osterhaut S, Shingleton W W
Surg Gynecol Obstet. 1978 Feb;146(2):233-6.
The hospital records of 870 consecutive patients undergoing elective biliary tract operations during an eight year period were reviewed. Bacteriologic cultures of the biliary tract obtained on 451 patients were correlated with specific biliary tract abnormalities and with postoperative complications. The incidence of positive biliary tract cultures was higher in patients with common duct disease than in those with chronic gallbladder disease without common duct disease. Choledocholithiasis and partial obstruction of the common duct are viewed as important factors in causing a high incidence of postive biliary tract cultures. Eighty-eight per cent of patients who had undergone previous biliary tract decompression procedures had positive cultures. There was no difference in the yield of postive cultures taken from the gallbladder wall and the gallbladder bile. Forty-nine per cent of patients with common bile duct disease and positive biliary tract cultures had no history of clinical cholangitis. Postoperative wound infections were more common in patients with common duct disease. The microorganism responsible for postoperative cholangitis and septicemia can usually be cultured from the biliary tract at operation. Antibiotics significantly decreased the incidence of postoperative cholangitis and septicemia.
回顾了870例在8年期间接受择期胆道手术的连续患者的医院记录。对451例患者获取的胆道细菌培养结果与特定的胆道异常及术后并发症进行了关联分析。胆总管疾病患者的胆道培养阳性率高于无胆总管疾病的慢性胆囊疾病患者。胆总管结石和胆总管部分梗阻被视为导致胆道培养阳性率高的重要因素。曾接受过胆道减压手术的患者中88%培养结果为阳性。从胆囊壁和胆囊胆汁获取的培养阳性结果的检出率没有差异。胆总管疾病且胆道培养阳性的患者中49%无临床胆管炎病史。胆总管疾病患者术后伤口感染更为常见。导致术后胆管炎和败血症的微生物通常可在手术时从胆道培养出来。抗生素显著降低了术后胆管炎和败血症的发生率。
