Lykkegaard Nielsen M, Moesgaard F, Justesen T, Scheibel J H, Lindenberg S
Scand J Gastroenterol. 1981;16(7):937-40. doi: 10.3109/00365528109181826.
This prospective study of elective cholecystectomy investigated the frequency and type of bacteria in gallbladder bile at operation, the factors predicting the presence of bacteria in bile, and the relationship between bacteria in bile and subsequent wound sepsis. In 148 consecutive cases 23% of bile cultures were positive. The overall wound infection rate was 15%, but 91% of all wound infections occurred in patients with positive bile cultures. Eighty-five per cent of all positive bile cultures and 86% of all wound infections occurred in 37% of the patients, characterized by age over 60 years and/or a history of previous attacks of acute cholecystitis. We suggest that in elective cholecystectomy prophylactic antibiotics should be restricted to this group of patients to limit the use of antibiotics.
这项关于择期胆囊切除术的前瞻性研究，调查了手术时胆囊胆汁中细菌的频率和类型、预测胆汁中细菌存在的因素，以及胆汁中细菌与随后伤口感染的关系。在148例连续病例中，23%的胆汁培养呈阳性。总体伤口感染率为15%，但所有伤口感染中有91%发生在胆汁培养呈阳性的患者中。所有阳性胆汁培养的85%和所有伤口感染的86%发生在37%的患者中，这些患者的特征为年龄超过60岁和/或有急性胆囊炎既往发作史。我们建议，在择期胆囊切除术中，预防性抗生素应仅限于这组患者，以限制抗生素的使用。
