Bacteriology and Antibiotic Selection in Biliary Tract Surgery

Abstract

ALTHOUGH numerous reports have been published during the last half century describing the bacteriology of the biliary tract in normal and pathologic states, little application has been made of these data in the treatment of patients. In cases of biliary tract stones and inflammation, little agreement is found on which patients, if any, should be treated with antibiotics or which agents should be used. It was the purpose of this investigation to ascertain which patients with biliary tract disease might be most threatened by bacterial infection and which antibiotics might be most effective for prophylactic use. Material One hundred and ten consecutive operations on the biliary tract were reviewed. The operations were performed over a period of three years and represent populations of county, Veterans Administration, and private hospitals. At operation, cultures were made of gallbladder or common duct bile or both, and in some cases the gallbladder wall. Except