Postoperative incidence of bile infection in patients with biliary lithiasis. Relation to the supplementary procedure after choledochotomy.
To assess the incidence of bile infection in patients undergoing elective biliary surgery for chronic calculous biliary disease, 737 patients with colecystolithiasis or choledocholithiasis are presented in this paper. It has been shown that the incidence of bile infection in those patients, despite the fact that they all underwent elective surgery, is not inconsiderable and is furthermore associated with a significant mortality and morbidity rate. These features were seen to occur in a statistically higher incidence in patients with common bile duct stones, where a relation has been shown to exist between the incidence of postoperative bile infection and the supplementary procedure which had to be carried out after choledochotomy. It was a striking finding to observe that 70% of those patients with initially sterile bile became infected during the postoperative period of exogenous contamination through the T-tube. It is postulated that T-tube drainage has to be used with great precaution, and that even then, should be avoided in patients in whom either a primary common bile duct closure, or an internal drainage can be carried out.
D000328:Adult; D000368:Aged; D002761:Cholangitis / Q000453:epidemiology / Q000209:etiology*; D002769:Cholelithiasis / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects; D005260:Female; D042882:Gallstones / Q000601:surgery; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies