Original communication| Volume 75, ISSUE 4, P578-583, April 1974

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Hazards of surgical treatment due to microorganisms in the bile

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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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