Association between Intraoperative Bactibilia and Postoperative Septic Complications in Biliary Tract Surgery

Abstract

Background: The present study intended to clarify the role of biliary bacteria in the development of postoperative septic complications in patients undergoing biliary operations and need for antibiotic prophylaxis.

Patient and methods: A total of 121 patients with various biliary tract diseases underwent various surgical interventions. The relation between contaminated ductal bile and postoperative septic complications was analyzed prospectively.

Results: 42/121 patients were bile culture positive (B+) while 79/121 patients were bile culture negative (B-).14 patients in B (+) group developed septic complications compared to only 3 patients in B (-) group (P = 0.0001). In B (+) group, bacteria found in ductal bile were also detected in infected sites of 85% of patients with septic complications. In B (+) group postoperative antibiotic modification significantly (p=0.001) reduced infectious complications.

Conclusion: Infected bile plays a critical role in development of post operative septic complications. Hence patients with risk factors for bactibilia should receive prophylactic antibiotics covering endogenous gram negative organisms which should be modified in postoperative phase according to the results of sensitivity. However this issue requires further investigations by studies conducted on similar lines.