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The occurrence of microorganisms in the bile at the time of operation has been recorded from 150 cases. Positive cultures were invariably present in patients requiring emergency cholecystectomy and in 90 percent of patients with stones in the common bile duct who were jaundiced at the time of operation. The incidence of infected bile in subjects undergoing elective surgery for cholelithiasis, but who were not jaundiced was only 17 percent. The importance of these bacteria as a cause of postoperative morbidity was also studied. Wound sepsis was twice as common when surgery was undertaken in the presence of bacteria in the bile. Infective complications were doubled when the common bile duct was explored as a result of microorganisms isolated in the T tube after operation. In addition to local sepsis, bacteremia, caused by organisms previously cultured from the bile, was an additional hazard in ten patients after operation. This occurred most often after cholangiography. There were three cases presenting with endotoxic shock, two of which accounted for the only deaths in this study.
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- Biliary excretion of antibiotics in man.Gut. 1968; 9: 536
- Surgery of the biliary tract: Mortality and complications of cholecystectomy and choledochostomy for chronic cholecystitis.New Engl. J. Med. 1956; 254: 155
- Rifamide in acute cholecystitis.Br. Med. J. 1971; III: 284
- Kocher's periampullary approach for common bile duct calculi.Br. J. Surg. 1973; 60: 117
- Primary closure of the common bile duct.Br. J. Surg. 1960; 47: 661
- Percutaneous transhepatic cholangiography.Surg. Clin. N. Am. 1967; 47: 1095
- Demonstration of the close relationship between bile capillaries and sinusoids walls.Acta Anat. 1953; 17: 105
- Bacteriological investigation of the biliary system and liver in biliary tract disease correlated to clinical data and micro structure of the gall bladder and liver.Acta Chir. Scand. 1958; 116: 461
- An evaluation of operative cholangiography as a guide to common duct exploration.Ann. Surg. 1959; 150: 1086
- Cholangio-venous reflux during cholangiography—an experimental and clinical study.Acta. Chir. Scand. 1962; 123: 111
- Choledochometry and transduodenal sphincterotomy.Ann. R. Coll. Surg. Engl. 1972; 51: 250
- The aetiology and prevention of pancreatitis following biliary tract operations.Br. J. Surg. 1973; 60: 149
- Fatal endotoxic shock of biliary tract origin complicating trans-hepatic cholangiography.Br. Med. J. 1973; 3: 147
- Occurrence and antibiotic sensitivity of aerobic bacteria in the bile and their role in postoperative inflammatory complications in biliary tract diseases.Acta Chir. Scand. 1958; 117: 379
- Ampicillin levels in human bile in the presence of biliary tract disease.Br. Med. J. 1969; III: 88
- Percutaneous transhepatic cholangiography—experience with 54 cases.Can. Med. Assoc. J. 1969; 100: 110
- Cephalexin levels in human bile in the presence of biliary tract disease.Br. Med. J. 1972; II: 441
- Bacteria and diseases of the biliary tract.Gut. 1971; 12: 487
- Origin of bacteria in bile duct bile.Lancet. 1967; II: 790
- Routine cholangiography at operation for gall stones.Acta Chir. Scand. 1952; 103: 175
- Percutaneous transhepatic cholangiography: A study of 115 cases.Can. Med. Assoc. J. 1968; 99: 513
- The role of bacterial infection in acute cholecystitis—a prospective clinical study.Milit. Med. 1969; 134: 416
Accepted: July 24, 1973
© 1974 Published by Elsevier Inc.