Search

This article discusses the importance of bile cytology in diagnosing hepatobiliary diseases. Bile cytology has become a key component of diagnostic workups at Tufts University's Foster Hospital for Small Animals. The article highlights various cytologic findings from bilious samples, including the detection of biliary flukes and protozoal zoites. Bile cytology can also identify bacteria, mucus, calcified material, and biliary microliths. The authors emphasize the need for standardized fixation and staining methods to optimize the accuracy of bile cytology and call for further research to establish clear correlations between cytologic findings and specific pathologies. [Extracted from the article]

Background: Bactibilia, or the presence of bacteria in bile from the gallbladder, may contribute to the development of septic complications. It has been related to increased rates of surgical site infection after cholecystectomy. Laparoscopic cholecystectomy is the definitive treatment for cholelithiasis and cholecystitis. Advanced age, acute cholecystitis, ERCP, and gallstones are important risk factors for the development of bactibilia. This study aims at showing the effect of bactibilia on the course of laparoscopic cholecystectomy. Materials and methods: This are a prospective case-control study to be conducted at Govt. General Hospital, Vijayawada at Dept. of General Surgery over 1 year on 50 patients. Patients with asymptomatic Cholelithiasis of age 18-60 are included in the study and patients with hemoglobin < 10 gm%, hypoalbuminemia < 2.5 gm/dL, patients in acute sepsis, patients with HbA1c >6.5%, hypertension (>139/89 mm of Hg) and BMI > 30 and patients in an emergency setting and patients who have not consented for the study were excluded from the study. None of the patients received pre-operative antibiotics. Intra-operatively, bile is collected from the gall bladder and sent for microbiological culture in aerobic and anaerobic media for 3-5 days. Patients are divided into: Group A - Microbiological culture positive for microbes and Group B - Microbiological culture sterile. Both groups will be analyzed for the duration of hospitalization after surgery, post-operative wound infection, and any other complications encountered. Results: Out of the 50 patients, 32 were males and 18 were females. The mean age of the patients was 43.5 ± 9.6 years. The mean BMI was 27.1 ± 4.7. Of the total 25 samples positive for bile culture, 11 were E. coli, 7 were Klebsiella, 3 were Enterobacter spp., 2 were Acinetobacter spp., and the remaining were 2 Viridans streptococci. All the bacteria were sensitive to Amikacin. All except Acinetobacter were sensitive to gentamycin and imipenem. All except one case of E.coli were susceptible to ciprofloxacin. The incidence of port site infection, prolonged fever, intra-abdominal abscess, pneumonia, wound healing duration, and hospital stay were significantly higher in group A compared to group b (pvalue < 0.05). Conclusion: Bactibilia affects the outcomes of laparoscopic cholecystectomy in terms of prolonged hospital stay, increased incidence of wound infection, duration of wound healing, and fever. [ABSTRACT FROM AUTHOR]

Objective: Although preoperative biliary stenting (PBS) restores enterohepatic circulation during the preoperative period, its postoperative outcomes remain unclear. This study aimed to evaluate the effects of PBS on bacterial colonization in bile fluid and postoperative morbidity and mortality rate for pancreatic surgery. Methods: A total of 70 patients who underwent pancreaticoduodenectomy due to periampullary tumor between January 2016 and May 2020 were analyzed retrospectively. Patients were divided into PBS and non-PBS groups. Intraoperative and postoperative outcomes were compared between the two groups. Results: The rate of positive growth in bile culture was significantly higher in the PBS group (89.2%) compared with the non-PBS group (9.5%) (p<0.001). The rates of postoperative infectious complications were found to be 85.7% and 28.5% in PBS and non-PBS groups, respectively (p<0.001). In the PBS group, the rate of postoperative complications increased with the time interval between stenting and surgery (p=0.007). There were no significant differences in both groups in terms of length of hospital stay and postoperative mortality (p=0.186 and p=0.294, respectively). Conclusion: Biliary stenting before pancreaticoduodenectomy increases the complications such as bacterial colonization in bile fluid, postoperative wound site infection, and intra-abdominal abscess. The prolonged time between PBS and surgery increases the rate of postoperative infectious complications. [ABSTRACT FROM AUTHOR]

Background: Infectious complications after pancreaticoduodenectomy (PD) are a major cause of morbidity. The association of bactibilia with the occurrence of surgical site infection (SSI) is debatable. Patients and Methods: Consecutive patients who underwent PD between July 2019 and December 2020 were included. All patients underwent standard pre-operative preparation and imaging. Pre-operative biliary drainage (PBD) was done as clinically indicated. A bile sample was collected just before the transection of common bile duct (CBD). Post-operative outcomes including SSI were analyzed. Results: Fifty-four patients were assessed for enrollment; 50 were found to be resectable during surgery and were included. The incidence of bactibilia was 46%. Nineteen (38%) patients developed SSIs and the occurrence was higher in patients who had positive bile culture (14 [60.8%] vs. 5 [18.5%]; p = 0.002). A similar organism between bile culture and SSI was seen in nine (64.2%) of 14 patients. Patients who had positive bile culture had more frequent change of antibiotic (16 [69%] vs. 8 [29.6%]; p = 0.005) and required prolonged duration of postoperative antibiotic agents (12 days [IQR, 8-14] vs. 8 days [IQR, 6-10]; p = 0.003). There was no association between bile culture growth and development of post-operative pancreatic fistula, delayed gastric emptying, and post-operative pancreatic hemorrhage. Patients with bactibilia had prolonged post-operative stay (17 days [IQR, 11-20] vs. 11 days [IQR, 8-14]; p = 0.010) and severe post-operative complications (8 [34.7%] vs. 2 [7.4%]; p = 0.008). Conclusions: Bactibilia is associated with the development of SSI and may provide a guide in selection of antibiotics. [ABSTRACT FROM AUTHOR]

Aims: The emerging biliary colonization of microorganisms in patients with biliary diseases may be devastating. Recent evidence suggests that age and gender may influence changes in the microbial composition of gut microbiota. To study the relationship between these parameters on bile microbiota, we retrospectively reviewed positive bile cultures following an endoscopic retrograde cholangiopancreatography (ERCP) in a QA-certified academic surgical unit of a single institution. Methods: 449 positive bile cultures from 172 Italian patients with diseases of the biliopancreatic system hospitalized from 2006 through 2017 were investigated for aerobic, anaerobic, and fungal organisms. The patients were stratified into four age intervals (22−66, 67−74, 75−81, and 82−93 years) and followed up for five years. Results: Gram-positive bacteria (GPB) was negatively associated with age only in multivariate analysis (Rpartial = −0.114, p = 0.017), with younger patients prone to harbor GPB and older patients likely to have Gram-negative bacteria (GNB). There was a definite link with the male gender using both univariate and multivariate analysis (p < 0.001). Enterococcus spp. was the most common strain identified in patients with GPB except for patients aged 67−74 years for male (95.2%) and female (80.9%) patients. Escherichia coli and Klebsiella spp. were most frequent than others in every group analyzed. Analogous results were found for bacteria Non-fermenting Gram-negative bacilli (NFGNB), such as Pseudomonas spp. and Stenotrophomonas spp. apart of the 2nd quartile. Conclusions: Our study strengthens the bond of age and gender with bile microbiota composition and suggests that further investigations may be required in targeting the aging microbiome. Other studies should also focus on Mediterranean epidemiological characteristics and antibiotic resistance surveillance system strategies

• This investigation is the first study to evaluate the human bile microbiota with the most extended follow-up using the STROBE guidelines in Italy in a homogenous Italian population. • Enterococcus spp. was the most common strain identified in patients with GPB except for patients aged 67−74 years for male (95.2%) and female (80.9%) genders. • E. coli and Klebsiella spp. were most frequent than others in every group analyzed. • Analogous results were found for bacteria Non-fermenting Gram-negative bacilli (NFGNB), such as Pseudomonas spp. and Stenotrophomonas spp. apart 2nd quartile. The emerging biliary colonization of microorganisms in patients with biliary diseases may be devastating. Recent evidence suggests that age and gender may influence changes in the microbial composition of gut microbiota. To study the relationship between these parameters on bile microbiota, we retrospectively reviewed positive bile cultures following an endoscopic retrograde cholangiopancreatography (ERCP) in a QA-certified academic surgical unit of a single institution. 449 positive bile cultures from 172 Italian patients with diseases of the biliopancreatic system hospitalized from 2006 through 2017 were investigated for aerobic, anaerobic, and fungal organisms. The patients were stratified into four age intervals (22−66, 67−74, 75−81, and 82−93 years) and followed up for five years. Gram-positive bacteria (GPB) was negatively associated with age only in multivariate analysis (R partial = −0.114, p = 0.017), with younger patients prone to harbor GPB and older patients likely to have Gram-negative bacteria (GNB). There was a definite link with the male gender using both univariate and multivariate analysis (p < 0.001). Enterococcus spp. was the most common strain identified in patients with GPB except for patients aged 67−74 years for male (95.2%) and female (80.9%) patients. Escherichia coli and Klebsiella spp. were most frequent than others in every group analyzed. Analogous results were found for bacteria Non-fermenting Gram-negative bacilli (NFGNB), such as Pseudomonas spp. and Stenotrophomonas spp. apart of the 2nd quartile. Our study strengthens the bond of age and gender with bile microbiota composition and suggests that further investigations may be required in targeting the aging microbiome. Other studies should also focus on Mediterranean epidemiological characteristics and antibiotic resistance surveillance system strategies [ABSTRACT FROM AUTHOR]

Background: Patients with periampullary tumors frequently undergo endoscopic biliary investigations and biliary drainage (BD) prior to surgery. Recent literature shows a shift of the biliary microbiome toward more resistant bacteria in patients having BD. This study aimed to evaluate the local microbiome and changes induced by BD and related antibiotic exposure and to consider the choice of antibiotic for peri-operative prophylaxis. Methods: A single-center retrospective cohort study included patients operated on for periampullary tumors between January 2013 and November 2017. All patients had intra-operative bile samples taken for culture and peri-operative antibiotic use as well as documentation of complications according to the Dindo-Clavien classification. Results: A total of 37 patients were included. All received pre-operative endoscopy, and 29 (78%) had BD preceded by administration of ceftriaxone or metronidazole. Intra-operative antibiotic prophylaxis consisted of cefuroxime (92%) or ceftriaxone (13%) combined with metronidazole (100%). Bacterial contamination of bile samples was more common in the BD group than in the no biliary drainage (NBD) group (93% vs 38%; p < 0.01). A shift was observed from bile containing mainly Escherichia coli and Streptococcus spp. toward Enterococcus faecalis (0 in the NBD group versus 44.8% in the BD group; p < 0.01), Enterococcus faecium (0 versus 23%; p = 0.3), and Candida albicans (0 versus 34.5%; p = 0.08). Post-operative antibiotic modifications were common. No difference was found regarding Dindo-Clavien complications, post-operative stay, or antibiotic use in the two groups, although one patient in the NBD group who had pre-operative biliary endoscopy with antibiotic prophylaxis developed a fatal septic clot caused by Escherichia coli resistant to cefuroxime. Conclusions: We observed a significant change toward colonization by enterococci and fungi in the microbiome of patients who had pre-operative biliary investigations or drainage with antibiotic prophylaxis. These findings indicate that bile samples should be obtained systematically during surgery for periampullary tumors to guide any post-operative antibiotic therapy and peri-operative antibiotic prophylaxis and might need adaptation to target the modified microbiome. [ABSTRACT FROM AUTHOR]

Aim: This study aims to identify the frequency of bacteriobilia, commonly isolated bacteria and their antibiotic susceptibility pattern from cancer patients with periampullary carcinoma attending a regional cancer center in the North-East India. Materials and Methods: This was a retrospective 1-year study of patients with obstructive jaundice due to periampullary carcinoma treated between January 2018 and December 2018. Intraoperative bile samples were obtained for microbiological analysis after transection of the common bile duct. Bile specimens were transported to the microbiology laboratory, and processing was done according to the standard protocol used in our clinical microbiology laboratory. Results: Intraoperative bile samples were obtained from 27 patients, and in 21 (77.77%) patients, it was culture positive. Stenting was done in 10 (37.07%) patients, and in those who underwent stenting, microbial contamination of bile was increased significantly (80%) compared to 61.90% in those without stenting. Organisms isolated were Escherichia coli 9 (42.85%), Klebsiella pneumonia 7 (33.33%), Pseudomonas 3 (14.28%), and Enterococcus cloacae 2 (9.52%). Carbapenamase producing E. coli(n = 1) and K. pneumonia (n = 1) was isolated from the two stented patient and one was vancomycin-resistant enterococcus (n = 1). Conclusion: Patients who underwent stenting for periampullary carcinoma had a significant risk for acquiring infection with multidrug-resistant bacteria. [ABSTRACT FROM AUTHOR]

Bile is a lipid-rich sterile solution produced in the liver that can be infected resulting in bactibilia. A higher incidence of postoperative infectious complications has been seen in patients with bactibilia. Recently, gram-negative bacteria have been linked to a tumor-associated inflammatory status. This study is a retrospective cohort study of 39 patients, who are over 80 years of age only (53.85% males and 46.15% females), hospitalized with diseases of the biliopancreatic system in one teaching hospital in Italy from January 2011 to December 2012 with a follow-up of 5 years. The most common biliary diseases after surgery were pancreatic head cancer (p < 0.0001) and gallbladder cancer (p = 0.0051), while the most common bacteria in the bile were E. coli (p = 0.0180) and Pseudomonas spp. (p < 0.0001). Uni- and multivariate linear correlation analysis revealed that patients with pancreatic head cancer had low survival times compared to patients with other diseases. Moreover, the bacterium type was a positive predictor of survival time compared to other variables. Our data confirm E. coli as a pathogen in patients with gallbladder and pancreatic cancer. Although the influence of bactibilia in developing surgical complications is limited, we consider that its composition is crucial to properly address the antibiotic treatment in biliary tract infections, especially in the elderly. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Cholecystocentesis can be part of the diagnostic workup of hepatobiliary disease in small animals, but literature on cytological evaluation of bile is scant. Objectives To determine the diagnostic utility of cytological assessment of bile aspirates. Animals Fifty-six and 78 client-owned dogs and cats, respectively, with bile collected by cholecystocentesis and submitted to our diagnostic laboratory between 1999 and 2014. Methods Retrospective study describing cytological findings of bile, concurrent bacterial culture results, hematological and serum biochemical data, gallbladder biopsy results, as well as final diagnosis and complications after cholecystocentesis. Results Infectious agents were found in 30% of canine and 22% of feline bile aspirates, and inflammation in 5% and 19% respectively. Presence of microorganisms was more often detected on cytological examination (24%) than by culture (21%). The most common bacterial isolates were Escherichia coli and Enterococcus spp., isolated from 14.8% and 6.7% of cultured samples respectively. Only increased canine pancreatic lipase immunoreactivity concentration ( cPLI) was significantly associated with the presence of microorganisms, inflammatory cells, or both in bile. Clinically relevant complications of cholecystocentesis occurred in 2 dogs. The majority of the animals undergoing cholecystocentesis suffered from hepatic, pancreatic, gastrointestinal disease, or a combination thereof. Conclusions and Clinical Importance Cytological examination of bile is inexpensive and straightforward, and yields diagnostically relevant information that precedes and complements bacterial culture. [ABSTRACT FROM AUTHOR]

Abstract: A prospective study was carried out between July 1999 and July 2001, of 50 patients of both sexes, between 16 and 80 years of age, hospitalized in the Surgery ward of the Chiquinquirá Hospital in Maracaibo, and diagnosed with the pathology of non-acute, lithiasic or non-lithiasic bile infection. All were to undergo surgery of the biliar tree, for the purpose of determine the frequency of biliar infection, to establish the specific antibiotic sensibility of the bacteria in bile culture, to reduce the cost of therapeutic expenses, and to identify the most frequent specimens. The ages in which there was greater affectation was in the third and fourth decades of life. The female sex is most affected, with a total of 96% of the patients under study. The number of cultures that were positive was significantly high (35%). Gallbladder bile and choledocol duct cultures in which there was bacterial growth were appropriately the same, 18 (36%), against 17 (34%). The microorganisms that were isolated on most occasions were 9 aerobic bacteria (75%), and of these, the ones that grew with more frequency were the gram negative species (77.8%), and of these, the one that was more frequently positive in the cultures was Escherichia coli in 28.5% of the cases. Bacillus gram negative bacteria were reported as sensitive to antibiotics of the aminoglycosides and quinolons types, and sensitive to betalactamics that were administered in association with the inhibiting compound, betalactamase. The gram positive enterococcus isolate showed sensitivity to penicillin and its natural and synthetic derivates as well as to those associated with betalactamase inhibitors. The anaerobic bacteria that grew was reported sensitive to penicillin and cephalosporins of third and fourth generation, as well as to betalactamics associated with the inhibitors of the enzyme betalactamase. Resumen: Se realizó un estudio prospectivo entre julio de 1999 y julio de 2001, en 50 pacientes de ambos sexos, realizándose en cada uno cultivo de bilis vesicular y coledociano, con edades comprendidas entre los 16 y 80 años, hospitalizados en el Servicio de Cirugía del Hospital Chiquinquirá de Maracaibo con diagnóstico de patología biliar no aguda, litiásica o no litiásica para ser intervenidos en el árbol biliar, con el propósito de determinar la frecuencia de infección biliar, establecer la sensibilidad antibiótica específica de las bacterias en cultivos de bilis, reducir el costo del gasto terapéutico e identificar los especímenes más frecuentes. Las edades más afectadas son la tercera y cuarta década de la vida. El sexo femenino es el más afectado, con 96% de los pacientes objeto de estudio. El número de cultivos positivos fue significativamente alto (35%). Los cultivos de bilis vesicular y del conducto colédoco en los cuales hubo crecimiento bacteriano fueron aproximadamente iguales, 18 (36%), contra 17 (34%). Los microorganismos aislados en más ocasiones fueron las bacterias aerobias 9 (35%), y de éstas las que crecieron con más frecuencia fueron las especies Gram negativas (77.8%), de estas últimas la que más se aisló fue Escherichia coli en 28.5%. Las bacterias del tipo bacilos Gram negativos se reportaron sensibles a los aminoglucósidos y quinolonas, con sensibilidad a betalactámicos que se administran asociados a los compuestos inhibidores de la enzima betalactamasa. Los enterococos gram positivos aislados se mostraron sensibles a penicilina y sus derivados naturales y sintéticos, así como a los asociados a los inhibidores de betalactamasa. Las bacterias anaerobias que crecieron se reportaron sensibles a penicilinas y cefalosporinas de tercera y cuarta generación, así como a estos betalactámicos asociados a los inhibidores de la enzima betalactamasa.

Background: The gallstone is a recurring condition in the world. In autopsy studies in Mexico, the General Hospital of Mexico, reported a prevalence for both sexes of 14.3% (8.5% males and 20.4% for women); In non-pathological conditions bile is sterile and is controversial if bacteria are the cause of calculi or stones cause bacterial colonization. Material and methods: Our study is to present a case series of patients in whom laparoscopic cholecystectomy was performed with subsequent seeding of bile to document bacterial growth. Results: 40% of patients had bacterial growth in bile, with different antimicrobial susceptibility testing, post-surgical complications were infection of the umbilical wound and 11.1% attributed to any bacteria present in the bile. Conclusions: Gallstones and bacteria in bile are a frequent association, our study showed higher prevalence than that reported in the literature, bacterial growth does not seem to influence the final outcome of surgery in terms of infectious complications but yet to be determined if necessary antibiotic prophylaxis in laparoscopic cholecystectomy. Our recommendation is to use a dose of antibiotics for gram-negative coverage. [ABSTRACT FROM AUTHOR]

Abstract: Background: Obesity has been associated with worse infectious disease outcomes. It is a risk factor for cholesterol gallstones, but little is known about associations between body mass index (BMI) and biliary infections. We studied this using factors associated with biliary infections. Methods: A total of 427 patients with gallstones were studied. Gallstones, bile, and blood (as applicable) were cultured. Illness severity was classified as follows: none (no infection or inflammation), systemic inflammatory response syndrome (fever, leukocytosis), severe (abscess, cholangitis, empyema), or multi-organ dysfunction syndrome (bacteremia, hypotension, organ failure). Associations between BMI and biliary bacteria, bacteremia, gallstone type, and illness severity were examined using bivariate and multivariate analysis. Results: BMI inversely correlated with pigment stones, biliary bacteria, bacteremia, and increased illness severity on bivariate and multivariate analysis. Conclusions: Obesity correlated with less severe biliary infections. BMI inversely correlated with pigment stones and biliary bacteria; multivariate analysis showed an independent correlation between lower BMI and illness severity. Most patients with severe biliary infections had a normal BMI, suggesting that obesity may be protective in biliary infections. This study examined the correlation between BMI and biliary infection severity. [Copyright &y& Elsevier]

Abstract: Objectives: Whilst there are theoretical benefits from pre-operatively draining the biliary tree prior to pancreatoduodenectomy (PD), the current literature does not support this intervention. The aim of this study was to explore the relationship between pre-operative stenting, bactibilia and outcome in a large United Kingdom tertiary referral practice. Methods: Patients undergoing PD were identified from a prospectively maintained database. The presence or absence of a stent prior to PD, and the results of bile cultures taken at PD were related to the subsequent post-operative course and the development of complications. Results: 280 patients underwent PD for periampullary malignancies, all of whom presented with jaundice. 118 patients were stented prior to referral (98 ERCP, 20 PTC). Bile cultures were positive more frequently in the stent group (83% vs. 55%; p = 0.000002) and bactibilia was more common after ERCP than PTC (83% vs. 56%; p = 0.006). The overall prevalence of complications was 54% in the stented and 41% in the non-stented group (p = 0.03) with statistical significance achieved for pancreatic leak (p = 0.013) and haemorrhagic complications (p = 0.03). Comparing stent with no stent, there as no difference in the 30-day mortalities (8.5% vs. 6.8%; p = 0.6) or the 1-year mortality rates (35% vs. 28%; p = 0.21). Mortality rates in the infection versus no infection groups were comparable at 30 days (8.5% vs. 5.5%; p = 0.21), and at 1 year (30.7% vs. 26.4%; p = 0.25). Conclusions: Pre-operative stent insertion prior to PD is associated with increased morbidity but not mortality and this is greatest for stents placed at ERCP. [Copyright &y& Elsevier]

Aims. To determine the prevalence of bactibilia in patients undergoing cholecystectomy and to relate the presence or absence of organisms to the preoperative and postoperative course. Patients and methods. Patients undergoing cholecystectomy under the care of a single consultant surgeon during a continuous 5-year period were identified from a prospectively maintained departmental database. Symptoms, clinical signs, findings of investigations, details of treatment and postoperative care were noted. Risk factors for bactibilia (acute cholecystitis, common duct stones, emergency surgery, intraoperative findings and age > 70 years) were documented. Patients were divided according to the presence (B + ) or absence (B-) of bacteria on culture of their bile. Results. In all, 128/180 (70%) of cholecystectomies had full data available for analysis. Bacteria were identified in the bile of 20 (15.6%) patients (B+ group). The B+ group was significantly older at 63.78±9.7 versus 61.62±13.9 (p<0.05) and contained significantly fewer females than the B- group (p<0.05). All 20 patients (100%) in the B+ group had ≥ 1 risk factor, while these factors were present in only 29/108 (30.3%) of patients in the B- group (p<0.05). The overall incidence of infective complications was 20% in the B+ group compared with 0.9% in the B- group (p<0.05) and the bile-related infections were higher in the B+ group (p<0.05). Conclusions. The study demonstrated that while patients with complicated gallstone disease frequently exhibit bactibilia, patients with uncomplicated cholelithiasis have aseptic bile. The findings would suggest that prophylactic antibiotics should be limited to patients with risk factors for bactibilia. [ABSTRACT FROM AUTHOR]

The aim of this study was to correlate the bactibilia found after preoperative biliary stenting with that of the bacteriology of postoperative infectious complications in patients with obstructive jaundice. One hundred thirty-eight patients (83% malignant and 17% benign etiologies) with obstructive jaundice had both their bile and all postoperative infectious complications cultured. Eighty-six (62%) had preoperative biliary stents (stent group) and 52 (38%) did not (no-stent group). There were no differences for age, sex, incidence of malignancy, type of operation, estimated blood loss, transfusion requirements, hospital length of stay, morbidity, or mortality rates between the two groups. Of 31 infectious complications, 23 were in the stent group and eight were in the no-stent group (P > 0.05), but only 13 (42%) infectious complications had bacteria that were also cultured from the bile. Only wound infection (P = 0.03) and bacteremia (P = 0.04) were more likely to occur in stented patients. Taken together, these data show that preoperative biliary stenting increases the incidence of bactibilia, bacteremia, and wound infection rates but does not increase morbidity, mortality, or hospital length of stay. Jaundiced patients can undergo preoperative biliary stenting while maintaining an acceptable postoperative morbidity rate. [Copyright &y& Elsevier]

Background: Through experience it has been accepted that bile in normal conditions remains sterile. Bactibilia is a common finding in individuals at high risk or with complicated cholecystolithiasis, however few data prevails about the prevalence of bactibilia in patients operated on for uncomplicated laparoscopic cholecystectomy. There is s common usage of preoperative and postoperative antibiotics in the different patients without the existence of any actual bacteriologic and epidemiologic evidence., Material and Methods: 183 patients with diagnosis of cholecystolithiasis postoperated of laparoscopic cholecystectomy had their bile sent to bacteriology., Results: Bactibilia was identified in 31.95% of the cultures of mild cholecystitis and in 35.71% for moderate (p<.0001). A total of 125 negative cultures were obtained (68.3) and 58 positive (31.69%) with a prevalence of enterobacteria group (43.10%) and Enterococcus (27.58)., Conclusions: Comparing the groups according to severity there is a significant difference with regard to the presence of bactibilia, in addition to the bacterial groups cultivated. Fluoroquinolones and metronidazole is an option for the treatment of patients with the suspicion of bactibilia. The use of antibiotics is not justified in patients at low risk., (Copyright © 2016. Publicado por Masson Doyma México S.A.)