POSTOPERATIVE INFECTION AND PROPHYLACTIC ANTIBIOTICS IN HEPATOBILIARY SURGERY

Abstract

Sixty patients undergoing hepatobiliary surgery were subjected to a bacteriological exploration in terms of postoperative infection and the significance of prophylactic administration of flomoxef (FMOX) was studied. Intravenous administration of FMOX 4g/day was started during surgery and lasted for 7 days. Bacteria in the bile, washing solution used during surgery, and fluid drained from the patients were cultured. Nine of the 60 patients developed infection (infection group). Five patients had intraabdominal infection and the other 4 patients had wound infection. The mean age of the group with infection was higher than that of the group without infection. The proportion of patients who underwent surgery likely to result in contamination by bile or gastrointestinal juice was greater in the infection group. The detection rate of bacteria in the bile from the infection group was higher than that in the other group. Enterococcus, pseudomonas spp., and Staphylococcus epidermidis were cultured from the bile, washing solution, and purulent dischage from patients with infection. In patients with fever (37°C or more) for one week after the operation, the same bacteria were cultured from the drained fluid. Most postoperative infections occurred because of intraoperative or postoperative contamination, and the causative bactaria were not sensitive to Flomoxef.