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KMID : 0614619920240040820
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Korean Journal of Gastroenterology
1992 Volume.24 No. 4 p.820 ~ p.826
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Bacteriology of the Gallbladder wall in Biliary Tract Disease
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조남천
이연희/윤광수/김대성/유수영/강성준/노병선/김수용
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Abstract
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Many patiens with high-risk factors for bactibilia such as acute cholecystitis, do not have bacteria in the bile. Therefore, to evaluate significance of the bacteria in the gallgbladder wall, we prospectively performed a culture from the wall and
bile
of the gallbladder in 129 consecutive patients with biliary operations during the recent 11 month period. The number of the isolated organisms in wall and bile of the gallbladder were 142 and 148, respectively. Of the 90 patiets with positive
cultures
from the gallbladder wall, 9 (10%) had anaerobic organisms. It was somewhat lower rates than those of the bile (13.4%). The most common aerobic organisms in the bile and the gallbladder wall were E. coli, followed by Klebsiella, Enterobacter and
Enterococcus. The most common anaerobes were Bacteroides. Clostridium perfringens were isolated from the both sites in amll numbers. Fusobacterium was isolated from the bile in one case but not in the wall of the gallbladder wall. In 12 (9.3%) of
the
129 patiets, organisms were cultured only from the gallbladder wall. In 4 (3.1%) of the 129 patietns organisms were cultured only from the bile. The rates of positive cultures in the patients with acute cholecystitis were higher than those in
chronic
cholecystitis without statistical signifciance. The rates of positive sultures for anaerobes were somewhat higher in chronic cholecystitis than those in acute cholecystitis without significace. Patients who had positive gallbladder wall cultures
showed
higher rates of postoperative septic complications than patients with negative cultures. Organisms isolated from the infected wound were same in 6 of the 11 patients as in the bile or wall. The results of the cultures in the bile and gallbladder
wall
were similar. So bile culture would be sufficinet to expect the findings of bacteriology of the gallbladder wall.
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KEYWORD
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