title: Negative short-term impact of intraoperative biliary lavage in patients with hepatolithiasis.
abstract: OBJECTIVE
  To evaluate short-term outcomes following intraoperative biliary lavage for hepatolithiasis.
  
  
  METHODS
  A total of 932 patients who were admitted to the West China Medical Center of Sichuan University between January 2010 and January 2014 and underwent bile duct exploration and lithotomy were retrospectively included in our study. The patients were divided into the lavage group and the control group. Related pre-, intra-, and postoperative factors were recorded, analyzed, and compared between the two groups in order to verify the effects of biliary lavage on the short-term outcome of patients with hepatolithiasis.
  
  
  RESULTS
  Amongst the patients who were included, 678 patients with hepatolithiasis were included in the lavage group, and the other 254 patients were enrolled in the control group. Data analyses revealed that preoperative baseline and related intraoperative variables were not significantly different. However, patients who underwent intraoperative biliary lavage had prolonged postoperative hospital stays (6.67 d vs 7.82 d, P = 0.024), higher hospitalization fees (RMB 28437.1 vs RMB 32264.2, P = 0.043), higher positive rates of bacterial cultures from blood (13.3% vs 25.8%, P = 0.001) and bile (23.6% vs 40.7%, P = 0.001) samples, and increased usage of advanced antibiotics (26.3% vs 38.2%, P = 0.001). In addition, in the lavage group, more patients had fever (> 37.5 °C, 81.4% vs 91.1%, P = 0.001) and hyperthermia (> 38.5°C, 39.7% vs 54.9%, P = 0.001), and higher white blood cell counts within 7 d after the operation compared to the control group.
  
  
  CONCLUSIONS
  Intraoperative biliary lavage might increase the risk of postoperative infection, while not significantly increasing gallstone removal rate.
authors.affiliation: Ou Jiang, Ke Yang, Chun-Xian Cai, Yu Liu, Department of Surgical Oncology, The Second People's Hospital of Neijiang, Neijiang 641100, Sichuan Province, China.
authors.forename: Ou
authors.initials: O
authors.lastname: Jiang
authors.affiliation: Ou Jiang, Ke Yang, Chun-Xian Cai, Yu Liu, Department of Surgical Oncology, The Second People's Hospital of Neijiang, Neijiang 641100, Sichuan Province, China.
authors.forename: Rong-Xing
authors.initials: RX
authors.lastname: Zhou
authors.affiliation: Ou Jiang, Ke Yang, Chun-Xian Cai, Yu Liu, Department of Surgical Oncology, The Second People's Hospital of Neijiang, Neijiang 641100, Sichuan Province, China.
authors.forename: Ke
authors.initials: K
authors.lastname: Yang
authors.affiliation: Ou Jiang, Ke Yang, Chun-Xian Cai, Yu Liu, Department of Surgical Oncology, The Second People's Hospital of Neijiang, Neijiang 641100, Sichuan Province, China.
authors.forename: Chun-Xian
authors.initials: CX
authors.lastname: Cai
authors.affiliation: Ou Jiang, Ke Yang, Chun-Xian Cai, Yu Liu, Department of Surgical Oncology, The Second People's Hospital of Neijiang, Neijiang 641100, Sichuan Province, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Ou Jiang, Ke Yang, Chun-Xian Cai, Yu Liu, Department of Surgical Oncology, The Second People's Hospital of Neijiang, Neijiang 641100, Sichuan Province, China.
authors.forename: Nan-Sheng
authors.initials: NS
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000382:microbiology*; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000191:economics; D002681:China; D005260:Female; D042882:Gallstones / Q000175:diagnosis / Q000191:economics / Q000601:surgery / Q000628:therapy*; D017721:Hospital Costs; D006801:Humans; D007430:Intraoperative Care; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D007507:Therapeutic Irrigation / Q000009:adverse effects* / Q000191:economics / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Biliary lavage; Hepatolithiasis; Postoperative infection