Gallagher P, Ostick G, Jones D, Schofield P F, Tweedle D E
Br J Surg. 1982 Aug;69(8):473-4. doi: 10.1002/bjs.1800690814.
Direct microscopy of the bile was performed during cholecystectomy in 111 patients in an attempt to identify those with a high risk of wound infection. Bacteria were identified in 23 patients, 11 of 83 undergoing cholecystectomy alone and 12 of 28 undergoing exploration of the common bile duct (P less than 0.01). These 23 patients were randomly allocated to an antibiotic group or a control group; there was one wound infection in the antibiotic group and two in the control group. A total of 14 patients developed wound sepsis. Infection was more likely if the common bile duct was explored (6 of 28) rather than cholecystectomy alone (8 of 83). There was a poor correlation between microscopy and culture of the bile for bacteria and there was no increase in sepsis when bacteria were observed on microscopy. We were not able to identify a high risk group of patients by intraoperative microscopy of bile.
在111例患者行胆囊切除术时，对胆汁进行直接显微镜检查，试图识别出伤口感染高风险患者。在23例患者中发现了细菌，其中单纯行胆囊切除术的83例中有11例，行胆总管探查术的28例中有12例（P<0.01）。这23例患者被随机分为抗生素组或对照组；抗生素组有1例伤口感染，对照组有2例。共有14例患者发生伤口脓毒症。行胆总管探查术（28例中的6例）比单纯行胆囊切除术（83例中的8例）更易发生感染。胆汁的显微镜检查与细菌培养之间的相关性较差，且显微镜下观察到细菌时脓毒症并未增加。我们无法通过术中胆汁显微镜检查识别出高风险患者组。
