Factors Associated with Bactibilia and Septic Complications after Cholecystectomy in Lampang Hospital
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Abstract
Background : Bactibilia is the presence of bacteria in gall bladder bile. Association between bactibilia and septic complications after cholecystectomy is inconclusive. There is no previous study in Thailand.
Objective : To identify factors associated with bactibilia and its correration with septic complication after cholecystectomy in Lampang Hospital. Material and method : Retrospective analytical study of 73 patients underwent cholecystectomy in Lampang hospital between April 2009 and May 2011 by single surgeon was conducted. All patients had bile culture for aerobes during surgery and then divided into the negative and positive bile culture group. Clinical data, laboratory results and septic complication were
collected and analyzed by using descriptive statistics. Comparison between groups, correlation between bactibilia and septic complications was analyzed with Chi-square and t-test.
Results : The mean age was 60.5 ± 17.7 years (range, 15-95). 57.5% was female. Among 38 cases of complicated gallbladder diseases, 35 was acute cholecystitis. All of procedures were open cholecystectomy including 4 cases of conversion from laparoscopic surgery. Elective and emergent surgery shared nearly equal. Twenty-seven cases had positive bile culture (37.0%). The most common organisms were Escherichia coli (59.3%) and Klebsiella pneumoniae (18.5%). Factors associated with positive bile culture included age >70 years (p=0.012), complicated gallbladder diseases (p=0.026) and emergent surgery (p=0.049). Superficial
surgical site infection was found in 8 cases (11.0%). Among these, 7 cases had bactibilia. The positive bile culture group had significantly higher incidence of surgical site infection than the negative group (25.9% vs 2.2%, p=0.003).
Conclusion : Factors associated with bactibilia were age >70 years, complicated gallbladder diseases and emergent surgery. Patients with bactibilia had significantly higher incidence of surgical site infection.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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