Relation between postoperative infections and gallbladder bile leakage during laparoscopic cholecystectomies

Abstract

Gallbladder injury proved more frequent in laparoscopic cholecystectomies performed due to acute cholecystitis, while bile spillage increased the incidence of umbilical wound infection, particularly in the presence of remnants of stones, but there was no correlative increase in the incidence of intraabdominal collections or infections.

The Role of Prophylactic Antibiotics in Patients Undergoing Elective Cholecystectomy- A Randomised Placebo Controlled Recipient Blind Trial

“…21 Low-risk patients were defined as those who did not have acute cholecystitis, a recent history of acute cholecystitis, common bile duct calculi, jaundice, immune suppression, or prosthetic implants. 22 As patients converted to OC, with a history of previous biliary surgery, age > 60 years, and bile spillage were reported to be at higher risk of post-operative infections, [23][24][25][26][27] low risk patients should be also defined as those without any of these risk factors. On the contrary, highrisk patients were defined as those with the risk factors.…”

Lost Stones During Laparoscopic Cholecystectomy

“…Perforation of the gallbladder with bile and calculi falling into the abdomen is common in [3,8,20,23]. It occurs in 10% of cases [Strasberg,22].…”

“…It was believed that stones left in the abdomen would not cause problems [19,26,31,13]. Bile alone even infected, is not deleterious if aspirated, the cavity irrigated by saline solution, and antibiotic therapy instituted [8]. Recent reports by Catarci [3], Diez [8], Guy [10], Kent [13], Klaiber [14], Paul [17], Ponsky [19] and Targerona [23] report morbidity produced by abandoned stones and recommend that if possible all of them should be retrieved.…”

“…Intraabdominal stones, produce serous or purulent collections and may cause generalized peritonitis, depending of the size of the stones [8,21] and degree of bacterial contamination [33,24]. Large or pigmented stones [3,21] are more likely to produce these complications.…”

“…In 214 they were retrieved and in 40 left in the abdomen. Twelve [3,6,8,14,15]. In this paper we assessed the morbidity caused by stones abandones in the abdomen or port tracts.…”