Identification of bacteria in the bile by duodenal aspiration

Duodenal aspirates were collected after cholecystokinin administration in 47 patients before biliary surgery. Viable counts of bacteria in the duodenum were compared with operative bile cultures. In 30 patients with sterile bile, the duodenal fluid frequently contained small numbers of oropharyngeal commensals, but bacterial colony counts were > 105 organisms/ml in only 5 patients (17%). In 17 patients with biliary sepsis, duodenal colony counts were > 105 in 15 (88%). Provided that the total number of organisms in the duodenum was > 105, the presence of bacteria in the bile was accurately detected in 85% of patients and the type of bacteria identified in 77% of patients.