Are clinicopathological factors predictive of bactibilia in biliary tract diseases?

Abstract

Background: Biliary tract disease is very common in Indian side of Jammu and Kashmir and because of this we got prompted to undertake a study to find out the association between presenting features and bactibilia.

Methods: The study was conducted prospectively on 121 patients of various biliary tract disorders in the Department of Surgery, Government Medical College Jammu, India prospectively over a period of one year from March 2003-February 2004. Details of age, history, radiology, operation and postoperative course were noted and information obtained recorded on special forms. All the patients included in this study were given single shot of preoperative antibiotic at the induction of anaesthesia and antibiotics modified postoperatively on the culture report.

Results; After recording the observations made while managing these patients of biliary tract disease the results were analysed and entered into the individual patient’s protocol. The age range of our series of 121 patients was 15-74 years with a mean age of 42.5 years. There were 100 females and 21 males with male to female ratio of 4.7:1. Abdominal pain was the commonest symptom (98.3%) followed by dyspepsia (47.1%), abdominal lump (16.5%), jaundice (9.9%) and cholangitis (3.3%).Most of the patients had more than one presentation. Out of 121 cases 42(34.7%) turned out to be culture positive and rest of the cases turned out to be culture negative. In culture positive cases aerobes were identified in 38 (34.1%) and anaerobes were identified in 10 (8.2%) patients. The results of gram stain of bile were compared with bile cultures. Out of 121 patients gram staining was positive in 51(42.1%) patients. Among these patients bile cultures were positive in 42 (82.3%) patients.

Conclusion: It was concluded that the presence or absence of bactibilia can predict possibility to stratify patients in low and high risk group so that necessary pre-emptive measures be taken.