Bacteriological study of nidus of gallstones

Abstract

Background: Gallstone disease is common worldwide and majority of patients undergo surgical management. Since the advent of laparoscopic cholecystectomy surgeons has become less interested in its aetiology. Infection is a major factor in the formation of gallstones. There are many infective complications reported of gallstones spilled during cholecystectomy. Presence of bacteria or its DNA by microscopy does not prove the infective potential of such stones. Thus culture of the nidus of the gallstone is the gold standard method to identify any potentially infective bacteria within and to predict the infective potential of gallstones.Methods: Cross sectional study done in seventy patients admitted for elective cholecystectomy for a period of 24 months from August 2016 to July 2018 in Department of Surgery, Regional Institute of Medical Sciences, Imphal, India.Results: Of the 70 stones cultured for bacteria, 52 (74.3%) were sterile and 18 (25.7%) were positive for bacteria, among which 16 stones showed mono-microbial growth while 2 showed poly-microbial growth. Most commonly isolated organism was E. coli and Klebsiella followed by Pseudomonas, Enterococcus and Staph aureus.Conclusions: Moynihan‘s aphorism “gall stone is a tomb erected in the memory of the organism within it”, suggest bacteria inside gallstone to be dead but this study proves that bacteria can be viable inside gallstone and its complete retrieval should be done in case of spillage which may help in avoiding complications.