Bacteremia following postoperative choledochofiberscopy--a prospective study. 1996

M F Chen, and Y Y Jan
Department of Surgery, Chang Gung Memorial Hospital, Chang Gung College of Medicine and Technology, Taipei, Taiwan.

OBJECTIVE The following investigation was undertaken in order to determine the frequency and clinical consequences of bacteremia after postoperative choledochofiberscopy. METHODS A total of 100 patients were prospectively studied for the frequencies of bacteremia after postoperative choledochoscopy. RESULTS Positive blood cultures were obtained in 15%; at 5-minutes period in seven patients, at 15-minutes in eight patients and at 30-minutes in two patients. There were two patients with positive cultures at 5 minutes and 10 minutes periods. All the bacteria species cultured were aerobes. Enterococcus, E-coli and Klebsilla were the most commonly cultured bacteria. The frequencies of occurrence of bacteremia seemed not be influenced by the existence of residual stones, session of the endoscopy and duration of the procedure. Six of the 15 bacteremic patients developed cholangitis within 24 hours of the procedure. They all recovered with antibiotic treatment. Patients with negative blood cultures were not found with cholangitic symptoms after the postoperative choledochoscopy. CONCLUSIONS The results of our study indicated that fifteen percent of patients undergoing postoperative choledochofiberscopy are associated with bacteremia. We believe that with adequate aseptic preparation and meticulous, gentle manipulation, routine prophylactic antibiotics may not be necessary for postoperative choledochoscopy in selected conditions.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002769 Cholelithiasis Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS). Gallstone Disease,Cholelithiases,Gallstone Diseases
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001653 Bile Ducts, Intrahepatic Passages within the liver for the conveyance of bile. Includes right and left hepatic ducts even though these may join outside the liver to form the common hepatic duct. Bile Duct, Intrahepatic,Duct, Intrahepatic Bile,Ducts, Intrahepatic Bile,Intrahepatic Bile Duct,Intrahepatic Bile Ducts
D016145 Endoscopy, Digestive System Endoscopic examination, therapy or surgery of the digestive tract. Digestive System Endoscopic Surgical Procedures,Esophagogastroduodenoscopy,Surgical Procedures, Endoscopic, Digestive System,Digestive System Endoscopic Surgery,Endoscopic, Digestive System, Surgery,Endoscopic, Digestive System, Surgical Procedure,Procedure, Digestive System, Endoscopic, Surgical,Procedure, Endoscopic, Digestive System, Surgical,Procedures, Digestive System, Endoscopic, Surgical,Procedures, Endoscopic, Digestive System, Surgical,Surgery, Digestive System Endoscopic,Surgery, Endoscopic, Digestive System,Surgical Procedure, Endoscopic, Digestive System,Digestive System Endoscopies,Digestive System Endoscopy,Endoscopies, Digestive System,Esophagogastroduodenoscopies
D016470 Bacteremia The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion. Bacteremias

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