Bacteremia following postoperative choledochofiberscopy--a prospective study.
OBJECTIVE
The following investigation was undertaken in order to determine the frequency and clinical consequences of bacteremia after postoperative choledochofiberscopy.


METHODS
A total of 100 patients were prospectively studied for the frequencies of bacteremia after postoperative choledochoscopy.


RESULTS
Positive blood cultures were obtained in 15%; at 5-minutes period in seven patients, at 15-minutes in eight patients and at 30-minutes in two patients. There were two patients with positive cultures at 5 minutes and 10 minutes periods. All the bacteria species cultured were aerobes. Enterococcus, E-coli and Klebsilla were the most commonly cultured bacteria. The frequencies of occurrence of bacteremia seemed not be influenced by the existence of residual stones, session of the endoscopy and duration of the procedure. Six of the 15 bacteremic patients developed cholangitis within 24 hours of the procedure. They all recovered with antibiotic treatment. Patients with negative blood cultures were not found with cholangitic symptoms after the postoperative choledochoscopy.


CONCLUSIONS
The results of our study indicated that fifteen percent of patients undergoing postoperative choledochofiberscopy are associated with bacteremia. We believe that with adequate aseptic preparation and meticulous, gentle manipulation, routine prophylactic antibiotics may not be necessary for postoperative choledochoscopy in selected conditions.
Chen
M F
MF
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung College of Medicine and Technology, Taipei, Taiwan.
Jan
Y Y
YY
D016470:Bacteremia / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D001653:Bile Ducts, Intrahepatic; D002769:Cholelithiasis / Q000601:surgery; D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D005260:Female; D042882:Gallstones / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies