Clinical implication of bactibilia in moderate to severe acute cholecystitis undergone cholecystostomy following cholecystectomy

Je Ho Yoon,Hoo Young Chung,Ji Seon Oh,Kwang Yeol Paik

doi:10.1038/s41598-021-91261-9

Je Ho Yoon, Hoo Young Chung + Show 2 more

Open Access

https://doi.org/10.1038/s41598-021-91261-9

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Abstract

There is little evidence of clinical outcome in using antibiotics during the perioperative phase of acute cholecystitis with bactibilia. The aim of current study is to examine the effect of bactibilia on patients with acute cholecystitis and their perioperative clinical outcome. We performed a retrospective cohort analysis of 128 patients who underwent cholecystectomy for acute cholecystitis with moderate and severe grade. Patients who were positive for bactibilia were compared to bactibilia-negative group in following categories: morbidity, duration of antimicrobial agent use, in-hospital course, and readmission rate. There was no difference in morbidity when patients with bactibilia (n = 70) were compared to those without (n = 58) after cholecystectomy. The duration of antibiotics use and clinical course were also similar in both groups. In severe grade AC group (n = 18), patients used antibiotics and were hospitalized for a significantly longer period of time than those in the moderate grade AC group. The morbidity including surgical site infection, and readmission rates were not significantly different in moderate and severe grade AC groups. In moderate and severe AC groups, bactibilia itself did not predict more complication and worse clinical course. Antibiotics may be safely discontinued within few days after cholecystectomy irrespective of bactibilia when cholecystectomy is successful.

Highlights

There is little evidence of clinical outcome in using antibiotics during the perioperative phase of acute cholecystitis with bactibilia
Patients were divided into two groups depending on the presence of bactibilia and to the severity grade as moderate and severe grade according to the Tokyo guideline 18 (TG18)
Despite bactibilia being a common finding in acute cholecystitis (AC) and a potential risk factor for worse clinical course, the present study found no significant correlation between bactibilia and negative postoperative outcomes of cholecystectomy

Summary

Introduction

There is little evidence of clinical outcome in using antibiotics during the perioperative phase of acute cholecystitis with bactibilia. The morbidity including surgical site infection, and readmission rates were not significantly different in moderate and severe grade AC groups. In moderate to severe grade AC, clinical course of patients sometimes can be unstable due to the septic condition and it may correlate directly with microorganism in GB, which prolong the use of antibiotics. There is little evidence for the use of antibiotics and surgical outcomes during the perioperative phase of AC with regards to bactibilia. We hypothesize that there is difference regarding the use of antibiotics and the surgical outcomes during the perioperative phase of AC with regards to bactibilia.

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