Micro floral assessment of bile during elective cholecystectomy and its correlation with surgical site infection: A study of 104 patients

Background: Presence of viable bacteria obtained from gall bladder during elective cholecystectomy can be decisive in the outcome of gall bladder surgeries with reference to surgical site infection. Materials and Methods: 104 patients with symptomatic gall stone disease underwent elective cholecystectomy. Bile sample was taken intra operatively from gallbladder using a size 22 spinal needle before beginning gallbladder dissection in both open and laparoscopic procedures and sent for culture and sensitivity examination. The patients were then divided into two groups depending on the presence or absence of bacterial growth on bile culture. Results: No bacterial growth was observed on bile culture in 76 patients (73.1%). This supports that in majority of the cases the bile was sterile. In rest 26.9 % E. Coli was grown in 18.26 % and Klebsiella pneumonia in 8.66 % patients. On correlation of bile culture and surgical site infection, it was observed that positive bile culture had higher incidence of surgical site infection i.e. 14.2% which was statistically significant. Conclusion: There is increased incidence of surgical site infection in patients with infected bile than with sterile bile. A routine bile culture during cholecystectomy can be predictor of surgical site infection.