Abstract

ABSTRACTBackground: Cholelithiasis is one of the diseases with greater surgical indication. Currently, laparoscopic cholecystectomy is the gold standard in the treatment of cholelithiasis. Aim: To analyze the culture of bile from patients with cholelithiasis, mainly in the occurrence of brown and mixed stones. Methods: Was carried out a prospective study with 246 cases with biliary lithiasis who underwent elective laparoscopic cholecystectomy. Bile culture was performed in all. During anesthetic induction the patients received a single dose of intravenous cefazolin 1 g. At the end of the surgery, the gallbladder was punctured, its contents extracted and immediately placed in a sterile 20 ml propylene flask and promptly sent to bacterioscopy with Maconkey and blood agars. Incubation at 37° C for 24 h was carried out. A protocol was elaborated to include the main factors potentially related to cholelithiasis and the possible presence of associated bacterial infection. Results: Of the 246 patients, 201 had negative bile culture and 45 positive. Of the 45 patients with bacteriobilia, 34 had growth of a single type of bacterium in bile culture and 11 more than one. Conclusions: It was observed a relationship between bacteriobilia and age, suggesting that age is a risk factor for bacteriobilia. The use of antibiotic prophylaxis in the elderly is therefore recommended.

Highlights

  • The cholecystolithiasis is one of the diseases with high surgical indication

  • Bacteriobilia can be defined as the colony of bacteria in bile, not being necessarily followed by clinical or laboratory manifestations

  • A prospect study was realized in 369 cases of patients carriers of gallstones during January 2010 until August 2014, the patients were submitted to elective laparoscopic cholecystectomy in the Clinical Hospital of the Federal University of Triângulo Mineiro, Uberaba, MG, Brazil

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Summary

Introduction

The cholecystolithiasis is one of the diseases with high surgical indication. The gallbladder stones are present in 10% of the western population. Bacteriobilia can be defined as the colony of bacteria in bile, not being necessarily followed by clinical or laboratory manifestations. The protection of biliary ducts against colonization of microorganisms and infections are made by some defense mechanisms, for example: anatomic barriers, physical mechanisms (biliary flux and mucus); chemical factors (bile salts) and immunological defenses. When some of this mechanisms fails, the bacteria colonization and the infection can settle. The route of the bacteria to the biliary duct are not completely clarified. The clinical situation tends to get worse, showing morbidity and mortality

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